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Court Ruling Suspends Wash.'s Medicaid Limits On ER Visits

Ruby de Luna

Washington state's Medicaid program will suspend limits on emergency room visits. A Thurston County judge has ordered the state to halt the policy because it was developed without the proper rule–making procedure. KUOW's Ruby de Luna reports.


Last month, the state started cracking down on ER visits deemed unnecessary. Medicaid would pay for only three non–emergency visits a year.

The state came up with the new policy as a way to cut costs. It was also meant to discourage a small group of people who frequent the ER as a way to get pain medication.

The American College of Emergency Physicians along with three state medical groups sued. Doctors took issue with the state's list of 700 medical conditions deemed non–emergent. They say the list contains many conditions that are serious and potentially life threatening.

The lawsuit also contends the state drew up the list without adequate input from the medical community, and without taking public comments.

The state Health Care Authority administers Medicaid. Officials say they'll abide by the judge's orders.

At the same time, the agency has to comply with the Legislature's mandate to cut costs. The agency says it's reviewing its rule–making procedures to correct the deficiencies mentioned in the judge's ruling.

I'm Ruby de Luna, KUOW News.

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