A plan by the state Medicaid program to stop paying for emergency-room visits for all conditions deemed "nonemergency" — set to go into effect Sunday — has been suspended by Gov. Chris Gregoire pending the outcome of budget negotiations under way in the state Legislature.
A plan by the state Medicaid program to stop paying for emergency-room visits for all conditions deemed “nonemergency” — set to go into effect Sunday — has been suspended by Gov. Chris Gregoire pending the outcome of budget negotiations under way in the state Legislature.
Gregoire’s budget director, Marty Brown, said Saturday that Gregoire on Friday stopped the Medicaid plan from going into effect, noting growing legislative support for a less-drastic alternative.
The alternative plan, pushed by Rep. Eileen Cody, D-West Seattle, is a modified version of a proposal offered by emergency-room doctors and hospitals, Brown said.
As proposed by Medicaid, the change would have blocked payment for ER visits for hundreds of conditions and would have applied to all adults and children. Pressed by a shrinking budget, Dr. Jeff Thompson, chief medical officer for the state Medicaid program, said “overuse and abuse” of emergency rooms cost the state at least $21 million a year.
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A statewide group of emergency doctors, backed by the Washington State Medical Association, Washington State Hospital Association and the Washington Chapter of the American College of Emergency Physicians, temporarily blocked the Medicaid plan in court.
They then turned their attention to lawmakers, pressing them to adopt a less-drastic alternative that scraps the list of conditions and instead emphasizes case management of frequent ER users, controls on narcotic prescribing, and patient education, among other efforts.
The doctors argued that the Medicaid plan, as proposed, would shift costs to hospitals and ER doctors and deny care to people with real emergencies. Patients, under federal rules, would not have to pay.
Dr. Nathan Schlicher, an emergency doctor who represented the doctors and hospitals, said Gregoire’s action was “great news,” and that he hoped it signaled lawmakers’ intentions to move ahead with the alternative plan.
“We are excited about the recognition of the real savings in the plan and hopeful to continue working with the state to not only achieve real savings, but improve the quality of care delivered to Medicaid patients across the state,” he said.
Carol M. Ostrom: 206-464-2249 or firstname.lastname@example.org