New Jersey on the Verge of Capping Some Nonemergent Medicaid ED Visits at $140

Medicaid patients who go to the ED with what is later deemed to be a “minor or nonemergency case.” While the bill’s sponsor, Assemblyman Louis Greenwald, says it is designed to save the state and taxpayers money, provider organizations and hospitals are obviously not happy. Some 1.8 million residents get coverage through Medicaid, according to state reports, with patients in the fee-for-service managed-care program accounting for about 5% of that number. If the law takes effect, the commissioner of the state Department of Human Services will be tasked with creating a list of medical conditions defined as “low-acuity.” Greenwald’s hope is that the new rules would encourage people to use primary care providers and urgent care centers for nonemergencies in order to free up EDs (and the funds devoted to those visits) for true emergencies.