Bill Aims to Expand Access to Emergency Med Care

WASHINGTON — A bipartisan bill in the House aims to permanently expand access to emergency medical care for Medicare, Tricare and Medicaid beneficiaries. 

Introduced by Reps. Jodey Arrington, R-Texas, and Vicente Gonzalez, D-Texas, the Emergency Care Improvement Act would head off a potential crisis caused by the impending end of the public health emergency associated with the COVID-19 pandemic.

Freestanding emergency centers are fully licensed emergency departments staffed by both emergency medicine trained physicians and registered nurses who are on-site 24 hours a day, seven days a week.

These facilities possess licensed pharmacies, clinical labs and advanced imaging services. FECs are state-licensed and adhere to the same standards and provide the same level of care as hospital-based emergency rooms.

To expand provider capacity during the COVID-19 pandemic, the Centers for Medicare and Medicaid Services issued a waiver in April 2020 to allow FECs to enroll as Medicare-certified hospitals and receive Medicare reimbursement for the duration of the public health emergency. 

Unless the statute is updated to provide permanent recognition, these beneficiaries will lose coverage at FECs in May, when President Biden officially terminates the public health emergency. 

“Over the past three years since Medicare began recognizing freestanding emergency centers, millions of seniors in Texas have benefitted from increased access to emergency care,” Arrington said in a written statement. 

“Unfortunately, the care these facilities provide — often at a lower cost to the Medicare program than most hospital-based ERs — will disappear for thousands of seniors if something isn’t done prior to the public health emergency ending on May 11,” Arrington said.

“The Emergency Care Improvement Act will allow seniors to continue utilizing low-cost, high-quality FECs, spurring much-needed competition in our health care system,” he added.

Over 110 FECs, mostly located in Texas, enrolled and have been providing high-quality emergency services for all kinds of emergency conditions, at a significant savings to the Medicare program, to thousands of Medicare beneficiaries. 

An actuarial study of Medicare claims data found that FECs did not increase overall utilization of emergency care services and actually saved Medicare programs 21.8% in lower emergency care payments for patients of similar acuity in hospital emergency departments, the lawmakers said. 

“A person’s access to high-quality health care should not be determined by their home address,” Gonzalez said in a written statement. 

“This bipartisan piece of legislation ensures Medicare, Tricare and Medicaid beneficiaries may access the high-quality medical treatment provided by freestanding emergency centers — expanding access and lowering costs for South Texans and patients across the country,” he said.

Dan can be reached at [email protected] and @DanMcCue