National Association of Psychiatric Health Systems
Situation
Under the Emergency Medical Treatment and Labor Act (EMTALA), both general and psychiatric hospitals are required to stabilize any patient who comes to an emergency room in a health crisis regardless of ability to pay. Stabilization of psychiatric emergencies often requires admission to ensure that patients are not a danger to themselves or others.General hospitals now receive reimbursement for Medicaid-eligible patients, but reimbursement is not provided to psychiatric hospitals serving adult patients (ages 21-64). Under the bill, general hospitals can continue to admit Medicaid patients to inpatient services and receive reimbursement with no changes; Medicaid patients who receive care in psychiatric hospitals would be covered under Medicaid, and psychiatric hospitals would be able to be compensated for these services.
The bill would resolve a current conflict in federal law between the Emergency Medical Treatment and Labor Act (EMTALA) and the Medicaid Institution for Mental Disease (IMD) exclusion.
Shortages of inpatient psychiatric beds at state psychiatric hospitals and general hospitals result in persistent and dangerous emergency room overflows with patients being routinely transferred from general hospitals to psychiatric hospitals or coming directly to a psychiatric hospital for emergency care.
The bill was developed in a bipartisan manner and has the support of key members of Congress and national organizations. It is a win-win for patients, family members, state and county government, psychiatrists, general hospitals, and psychiatric hospitals.
Solution
Rep. Tom Allen (D-ME) and Rep. Barbara Cubin (R-WY) on April 26 introduced the Medicaid Emergency Psychiatric Care Act of 2007, H.R. 2050, which allows Medicaid patients who receive care in psychiatric hospitals coverage under Medicaid and compensates psychiatric hospitals for these services. The legislation would result in patients receiving the right care at the right time and in the right setting instead of prolonged stays in emergency rooms and in hospital settings without psychiatric specialty care. It is anticipated that a Senate bill will be re-introduced this year. Original co-sponsors include:- Rep Berkley, Shelley [NV-1] - 6/26/2007
- Rep Cubin, Barbara [WY] - 4/26/2007
- Rep Gordon, Bart [TN-6] - 6/26/2007
- Rep Green, Gene [TX-29] - 7/16/2007
- Rep McGovern, James P. [MA-3] - 6/15/2007
- Rep McNulty, Michael R. [NY-21] - 5/24/2007
- Rep Pickering, Charles W. "Chip" [MS-3] - 6/26/2007
- Rep Wicker, Roger F. [MS-1] - 8/3/2007
