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Majority oppose limiting ER payments.

Seventy percent of Americans oppose insurance companies' efforts to deny payment for emergency department visits that result in diagnosis of a non-urgent medical condition, a recent poll found.

Conducted on behalf of the American College of Emergency Physicians, the poll also found 85 percent of respondents with regular medical providers who sought ER care said they could not have waited to see their regular providers.

Federal law requires health plans to cover visits to emergency departments based on an average person's belief that she or he may be suffering a medical emergency based on the person's symptoms, not the final diagnosis. Yet many health plans tell beneficiaries not to seek care unless they know they are having medical emergencies, and some states have been trying to cut back on Medicaid emergency payments.

"Patients should never be in the position of having to self-diagnose their own medical conditions out of fear their health plans won't pay," said David Seaberg, MD, FACEP, president of the American College of Emergency Physicians. "Even a skilled physician does not know your diagnosis when you walk in the door."

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Title Annotation:NATION IN BRIEF
Author:Currie, Donya
Publication:The Nation's Health
Article Type:Report
Geographic Code:1USA
Date:Aug 1, 2012
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