Update on patient access to EDs: Share good news
There is finally some good news on the patient protection legislative front: The Norwood/Dingell bill (HR 2723) was passed in the U.S. House of Represen tatives. This bill would establish a national standard of emergency care and protect patients from claims denials and requirements for prior authorization by managed care plans.
"The legislation passed by the House will ensure that all patients in managed care plans can access emergency care whenever and wherever they need it, without fear of being stuck with the bill," says John Moorhead, MD, FACEP, immediate past president of the American College of Emergency Physicians (ACEP) in Dallas.
The House bill, which was introduced by Rep. Charlie Norwood (R-GA) and John Dingell (D-MI) would establish a national prudent layperson standard and require health plans to base emergency care coverage on a patient’s symptoms and not a final diagnosis, says Moorhead.
HR 2723 also extends the prudent layperson standard to the approximately 161 million Americans with health insurance, unlike the legislation passed by the Senate [S. 1344], which only covered 48 million patients enrolled in self-insured health plans, explains Moorhead.
It is imperative that patients who pay for their health insurance be afforded the same emergency care protections as individuals enrolled in Medicare and Medicaid health plans, he stresses. "The emergency physicians of this country and our patients continue to call on Republicans and Democrats alike to take the steps necessary to pass meaningful patient protection legislation that includes the prudent layperson standard this year."
The bill will be a significant health care issue in this year’s presidential election, but it’s doubtful that legislation will be passed before then. "We are at point where it’s been passed by House of Representatives, but our proposal wasn’t accepted completely by the Senate version, so it’s in committee," says Michael Rapp, MD, FACEP, president of ACEP. "Hopefully it will ultimately be adopted, but there is still plenty of work to be done."
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