Physicians File Suit to Prevent Washington State Plan that Classifies more than 700 diagnoses as “non-emergent” for Medicaid Patients

Emergency physicians in Washington State today filed suit in the Superior Court of Washington for Thurston County against a state plan that would limit payment for Medicaid visits to three "non-emergency" visits to emergency departments each year and classify more than 700 diagnoses as "non-emergent," including chest pain, abdominal pain, miscarriage and breathing problems.

The Washington Chapter of the American College of Emergency Physicians said the basis for the suit is multi-factorial and includes:

*The state has not implemented a rule making process that included stakeholder comments; yet the plan is being forced on hospitals and providers with no warning.

*The state has violated requirements that this be a collaborative process as outlined by the legislature.

*The state has violated the requirements that this be a collaborative process as outlined by the legislature.

*The state has misconstrued the ability to bill patients for services.  Federal law prevents physicians from meeting Medicaid requirements for billing patients through EMTALA, and state law blocks hospitals from billing under charity requirements.

*The state is violating the federal Prudent Layperson standard by applying it to managed care patients.