ACEP Issues Statement in Response to Announcement by
the Coalition for Quality Affordable Healthcare
Washington, DC — Michael T. Rapp, MD, president of
the American College of Emergency Physicians (ACEP),
today issued a statement in regard to this week's
announcement from the Coalition for Quality Affordable
Healthcare about a plan that includes goals to make it
easier for patients to go to emergency departments and
for health plans to pay for emergency visits that a
"reasonable person" would consider an emergency:
"The nation's health plans are taking a step in the
right direction by including a standard of coverage for
emergency care in their recent announcement. ACEP
opposes leaving the development and enforcement of
standards for patient protection related to emergency
care to health plans. ACEP strongly believes the best
way to protect the rights of emergency patients is by
enacting the prudent layperson standard into law. A
national standard is essential to address the problems
that patients have experienced with barriers by health
plans to access to emergency care.
"Emergency physicians support provisions in the
House-passed Norwood-Dingell patients' bill of rights
that will protect patients from 'after-the-fact' claim
denials of emergency care. The prudent layperson
standard of emergency care should be a basic patient
protection for all Americans."
The prudent layperson standard would establish a
uniform definition of an emergency, which would
guarantee coverage of emergency care based on a
patient's symptoms, not his or her final diagnosis. It
would require health plans to cover emergency services
if a patient has symptoms that a person possessing an
average knowledge of health and medicine could
reasonably expect to result in serious impairment to the
patient's health. In addition, the standard would
prohibit health plans from requiring prior authorization
before seeking emergency care.
ACEP is a national emergency medicine medical
specialty society with more than 21,000 members. ACEP is
committed to improving the quality of emergency care
through continuing education, research, and public
education. Headquartered in Dallas, Texas, ACEP has 53
chapters representing each state, as well as Puerto Rico
and the District of Columbia, and a Government Services
Chapter representing emergency physicians employed by
military branches and other government agencies.
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