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State cracks down on ER abuse

Post by Kim Bradford on Sep. 25, 2011 at 7:01 pm with No Comments »
September 25, 2011 8:07 pm

Statehouse reporter Jordan Schrader has a story in Monday’s paper about the state looking to reduce emergency room misuse – and save millions in the process.

Under the new limits that take effect Saturday, the state will not pay for ER visits for Medicaid patients who make repeated trips to the ER for what the state considers nonemergencies.

Hospitals and doctors’ groups have aligned to fight the state, arguing that patients often don’t know if their symptoms warrant emergency care until they are seen by a doctor.

Jordan lists several conditions that will be deemed nonemergencies by the state, including nonspecific chest pain, kidney stones and some types of asthma attacks. Other diagnoses on the list are no-brainers (see: premenstrual tension and plantar warts).

The complete list of more than 700 conditions is below. Medicaid patients who are assigned these diagnoses at discharge will not have their next trip to the ER covered unless it is a true emergency.

Use the zoom tool at the upper righthand corner to make the text bigger.

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