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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.