Alaska ACEP urges lawmakers to stop bill that would alter ER payment rules

The Alaska chapter of the American College of Emergency Physicians is urging state lawmakers not to pass a bill that would remove a rule that connects emergency care payment to a database that calculates these costs.

The bill would repeal the 80th Percentile Rule, which restricts balance billing from out-of-network providers. The state would instead use Medicare reimbursement rates to calculate emergency care costs. The rule, which was enacted to protect patients, helps to ensure Alaska residents have access to physicians and that these physicians are in the insurance company networks.

Using Medicare rates would bring negatively affect Alaska residents' emergency care since Medicare rates often change because of factors outside of the actual care costs, such as changes in the federal budget, said Benjamin Shelton, MD, president of the Alaska chapter of ACEP.

"The impact of SB 129 [the bill] would destabilize the Alaska emergency care network [and] the healthcare safety net of our state," Dr. Shelton said. "It also would increase healthcare costs for Alaskans."  

ACEP encourages opioid abuse education, citing the nationwide opioid crisis as a major driver in the state's high ER utilization. A report from the Alaska Department of Health and Social Services Division of Public Health found nearly 6,600 patients (6 percent) in Alaska accounted for $148 million in the state's emergency department spending in 2016.

ACEP is aiming to work with payers and lawmakers to reduce emergency care costs in ways other than cutting the 80th Percentile Rule.

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