WA Governor Suspends Medicaid Denial Plan, State Considers Physician-Drafted Alternative

March 31 – Washington Gov. Chris Gregoire suspended the April 1 implementation of the Zero Tolerance Policy that would have denied payments for treatment of Medicaid patients that the state retrospectively deemed to be non-emergency visits, according to WA/ACEP member Dr. Nathan Schlicher. The state legislature is still in special session this week considering its budget, which is now expected to include a physician-penned alternative plan, designed to help the state reach some of its budget tightening goals, but also uphold the national prudent layperson standard. “We hope that the legislature will close business next week, include in their work our alternative plan that is already drafted into a proviso in the house budget, and let us get to the work of improving the delivery of care,” said Dr. Schlicher, Associate Medical Director at St. Joseph Medical Center in Tacoma, WA and Legislative Affairs Chairman for the Washington ACEP Chapter. The Washington Health Care Authority (HCA) originally had proposed limiting Medicaid patients to three ED visits that the state determined were not emergencies. But as a legal battle got underway, the state revised their plan and offered the Zero Tolerance Policy. Read more