In a brief issued the day after President Donald Trump’s address to Congress Tuesday, ACEP President Rebecca Parker, MD, asked Congress to consider recommendations from emergency physicians in the replacement process.
Here are 10 reform principles ACEP outlined.
1. Retain emergency services as a covered benefit for any insurance plan.
2. Ensure health insurance companies cover claims based on a patient’s symptoms and not the final diagnosis.
3. Require health insurers to make the data used to decide in- and out-of-network reimbursement rates transparent and ensure emergency services receive appropriate reimbursements.
4. Get rid of preauthorization for emergency services and guarantee parity in coverage and co-payments for in- and out-of-network emergency services.
5. Maintain protections for pre-existing conditions, no lifetime limits and allow children to remain on their parents’ health plan until age 26.
6. Protect physicians providing federally-mandated services under the Emergency Medical Treatment and Labor Act, providing patients care in federally declared disaster areas and physicians following clinical guidelines created by national medical specialty societies.
7. Ensure health savings accounts, health reimbursement accounts, association health plans and individual health pools continue and expand insurance benefits and access to emergency care services.
8. Delay repeal of CMS’ Innovation center until at least 2020 and repeal the Independent Payment Advisory Board as well as the excise tax on high-cost employer health benefit plans, known as the Cadillac Tax.
9. Ensure Medicare, Medicaid and the Children’s Health Insurance Program remain accessible.
10. Acknowledge freestanding emergency centers and other healthcare delivery models as integral to coverage innovation.
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