BATON ROUGE, LA — The Louisiana Department of Health and Hospitals recently published a Notice of Intent in the Louisiana Register to cut hospital payments for emergency services by implementing a flat-rate triage fee for some services in hospital emergency rooms. The LHA strongly opposes this proposed rule, which is a very narrow approach to a much larger problem with Louisiana’s healthcare system.
In January, the American College of Emergency Physicians gave Louisiana a D in a state-by-state report card on America’s Emergency Care Environment, down from a D+ in 2009, citing high rates of uninsured, lack of access to primary care, and poor health status among the reasons for the poor grade. In an effort to keep non-emergent patients out of the ER, we need to be working collaboratively toward improving access to primary care and addressing healthcare outcomes for Louisianians before they become chronic problems.
An ER triage fee translates into a cut to hospital ER funding, which would be in addition to the 26 percent cuts that hospitals have received since 2009. Hospitals are required under the federal EMTALA law to provide a medical screening examination to all patients who present to the ER for a condition perceived by the patient as an emergency. EMTALA requires that all patients be treated the same with respect to services provided regardless of the ability to pay or the payer. To meet these obligations, resources are required, and the proposed triage fee is significantly less than the actual cost of providing that care. With this additional cut to hospitals and their ERs, all Louisianians may face longer ER wait times and less access to emergency services.
DHH’s proposed rule would result in more profits for national insurance companies in the Medicaid Bayou Health program and less access to care for Louisiana’s most vulnerable patients. We strongly urge the Jindal administration to reconsider these harmful cuts and to work with the Legislature and healthcare community on a broader approach to addressing the high rates of uninsured patients, lack of access to primary care and the poor health risk factors affecting our residents.