EDPMA Concerned About Health Plans’ Threats To Cut Physician Reimbursement of Up To 50%

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The Emergency Department Practice Management Association (EDPMA) is concerned about health plans' systemic and drastic reductions in emergency medicine physician reimbursement and threats to physician group contracts under their misinterpretation of the No Surprises Act.

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EDPMA strongly believes that emergency physicians should be fairly reimbursed for the delivery of emergency care, and payers should do their part to not undermine the emergency medical health care delivery system or the overall health of our healthcare system.

The Emergency Department Practice Management Association (EDPMA) is concerned about health plans' systemic and drastic reductions in emergency medicine physician reimbursement and threats to physician group contracts under their misinterpretation of the No Surprises Act.

Health plan insurers like Cigna, UnitedHealthcare and Blue Cross Blue Shield are prioritizing profits over patient care by threatening emergency medicine physician groups in several states with contract termination if they do not agree to pay cuts upwards of 50% of the current in network rates.

If health plans continue to go unchecked, emergency physicians will not be able to offset the cost for uncompensated or undercompensated care without fair reimbursement from commercial plans. Medicare payments have not kept pace with inflation for two decades and Medicaid payments are even worse. At some point, emergency physician groups will not be able to adequately staff emergency departments. This will lead to holes in the healthcare safety net which could lead to longer waits for emergency care or the inability to staff emergency departments.

"EDPMA continues to hold payers accountable for systemic practices that do not acknowledge or compensate for the complex medical decision making required in the emergency department,” says Don Powell, DO, FACEP, EDPMA Chair of the Board. “We strongly believe that emergency physicians should be fairly reimbursed for the delivery of emergency care, and payers should do their part to not undermine the emergency medical health care delivery system or the overall health of our healthcare system. EDPMA is in the business of emergency medicine and will continue to advocate for its members and patients.”

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About EDPMA
The Emergency Department Practice Management Association (EDPMA) is the nation’s largest professional physician trade association focused on the delivery of high-quality, cost-effective care in the emergency department. EDPMA’s membership includes emergency medicine physician groups of all sizes, as well as billing, coding, and other professional support organizations that assist healthcare providers in our nation’s emergency departments. Together, EDPMA’s members deliver (or directly support) health care for about half of the 146 million patients that visit U.S. emergency departments each year. Visit http://www.edpma.org.

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Cathey Wise
EDPMA
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