"Emergency physicians have proposed a recently passed law in Connecticut as the solution, which requires the use of an independent and transparent charge database. We are urging policymakers at the state level to implement this solution, which will take patients out of the middle. Emergency physicians and other physicians who provide on-call services in the emergency department would be in-network if insurance companies paid fairly.
"No one chooses when they will need emergency care and should not be punished financially for having emergencies or discouraged from seeking medical attention when they are sick or injured. But significant co-pays and high deductibles effectively do exactly that. This is unacceptable and our patients deserve better.
"Health insurance companies have a history of data manipulation and not paying for emergency care. There have been significant reductions in insurance payments for emergency care, as much as 70 percent. They have taken gross advantage of patients and emergency medical providers since the ACA, arbitrarily slashing payments to physicians. The EMTALA mandate gives the insurance industry the upper hand and can exploit the situation, because the doctors have to see all patients, regardless of insurance status or ability to pay.
"An analysis of out-of-network emergency billing in the state of Florida found it to be rare. According to the data, which represented 10 percent of emergency visits in Florida, the average patient payment was just $49 – hardly the thousands of dollars that the insurance companies would like you to believe.
Dr. Parker adds that emergency physicians are asking the insurance companies to provide fair coverage for their beneficiaries and be transparent about how they calculate payments. State and federal lawmakers also need to ensure that health insurance plans provide adequate rosters of physicians and fair payment for emergency services.
ACEP is the national medical specialty society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies.
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SOURCE American College of Emergency Physicians (ACEP)