Washington must end Medicaid limits on ER

OLYMPIA – A court ruling Thursday is forcing Washington to temporarily repeal rules that seek to limit Medicaid coverage of emergency room visits for nonemergency care.

A Thurston County judge said the state did not follow proper procedures when it established a three-visit annual limit. Officials with the state’s Health Care Authority said they are going to rework the proposal through proper procedures and that the ruling from Judge Paula Casey did not address whether the larger effort is legal.

“We remain under a legislative mandate to implement this limit and contribute savings to help relieve the state’s extreme financial crisis,” said Health Care Authority Director Doug Porter in a statement.

The American College of Emergency Physicians has sued the state, arguing that the rules put patients at risk. The group has noted that the list of nonemergencies include chest pain and kidney stones, arguing that the rules force people to self-diagnose.

The ruling will allow groups to air concerns about the issue in public hearings.

“The state’s process has been arbitrary and capricious, and stopping it was clearly the right thing to do,” said Nathaniel Schlicher, legislative chairman of the Washington chapter of the emergency physicians group, in a statement. “We continue to be interested in a truly collaborative process to reduce unnecessary emergency room visits. We will not, however, stand by and allow a policy damaging to Medicaid enrollees to take effect.”

State officials implemented the rule a month ago, hoping to deter people who overuse the emergency room. The state projected that it would save more than $30 million over a two-year period.