Patients who visit an emergency room fearing they are suffering from a serious condition should be covered by their insurance regardless of the final diagnosis, according to the president of the American College of Emergency Physicians (ACEP).
In a teleconference call following the publication of an ACEP-commissioned poll
carried out by Morning Consult, Dr. Rebecca Parker,
president, said that the future of health care is unclear. She also said that her organization has not taken an official position on the U.S. House of Representatives bill published two weeks ago.
Parker said there are provisions in the Affordable Care Act (ACA), also known as Obamacare, and other federal laws that emergency physicians think should be protected by any new health care bill.
One of these is that patients should not be penalized for seeking care for symptoms they think are life threatening but turn out to be much less serious.
Ninety-five percent of Americans say health insurance companies should cover emergency medical care, according to the survey.
Nine in 10 registered voters said that health insurance companies should let patients know how they calculate coverage for emergency care. Over one-third said those payments should be determined using a transparent, independent cost database and formula.
This comes at a time when insurance companies are increasingly shifting more of the costs of health care onto patients and physicians by expanding high-deductible insurance plans with narrowing networks of providers, the ACEP said.
The survey also asked whether health insurance should cover people visiting the emergency department because they thought they were having a heart attack but were later diagnosed with a panic attack. More than 8 in 10, or 83 percent of Americans said that emergency visit should be covered.
The principle of covering medical care based on symptoms that most people would consider potentially life-threatening rather than the final diagnosis is called the “prudent layperson," Parker said.
This was codified into federal law, including in the ACA, following years of denials of coverage for emergency care by health insurance companies, she said. She urged lawmakers not to meddle with those provisions.
“Patients can’t choose where and when they will need emergency care, and they shouldn’t be punished financially for having emergencies," Parker said.
Dr. Jon Mark Hirshon, ACEP board of directors member and a professor at the University of Maryland School of Medicine, said in the teleconference that many people still delay seeking emergency care because of fears over out-of-pocket costs.
"Regardless of what Congress does, to reform the ACA, patients are always going to need emergency care," Hirshon said. "They should not fear paying a huge bill. When patients are in pain, they come to us. When they are scared, they come to us."
Emergency physicians are asking insurance companies to offer fair coverage for emergency care, he said.
Insurance should fairly cover emergency care, ACEP says
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