MANAGED CARE July 1998. ©1998 Stezzi Communications
Washington Initiatives
The Office of the Inspector General will provide guidance to managed care organizations and hospitals about appropriate emergency treatment and screening. OIG is concerned about the extent to which managed care organizations fail to provide or authorize emergency treatment.
HHS is annoyed about reports that a growing number of hospitals are refusing to treat emergency patients arriving through — or just outside — their doors. In Chicago recently, a 15-year-old shooting victim was refused treatment even though he was yards from an emergency room. ER staffers were uncertain about hospital policies governing treatment of patients outside its doors. HCFA responded by reviewing the hospital's ER treatment policies and threatening to cancel its Medicare eligibility if policies providing for care on its grounds — inside or outside its walls — were not put in place, regardless of the procedures of patients' or the hospital's managed care plans.