New guidelines for freestanding emergency rooms amid the COVID-19 pandemic gave more care options to Texas’ Medicaid and Medicare patients. Since April 2020, the announcement that freestanding ERs can provide reimbursement for patients is making easier access to care, especially during this delicate phase of coronavirus.

For the period of  COVID-19 pandemic, the independent and freestanding ERs in Texas and several other states can be recognized as health care providers for reimbursement in treating Medicaid and Medicare patients. This is an announcement of The Centers for Medicare & Medicaid Services. The freestanding ERs will be able to serve the community even better, from now on.

Medicaid and Medicare patients in the US: the new announcement of Texas

The executive director of the National Association of Freestanding Emergency Centers (NAFEC), Brad Shields stated that freestanding ERs across the state have seen a “substantial increase” of Medicare and Medicaid patients since the announcement and this is a victory for them. The change is a victory for these patients.

Patients will have the possibility to choose where to seek care. Previously, it was not like this. They could still seek care at a freestanding ER, but they were not sure if their Medicare coverage would cover them.

Many freestanding ERs in Texas have been advocating for this change to be made by US Congress and now the enrollment process is currently underway, according to the CMS guidance.

 

The experience of medical facilities of Texas: Medicaid and Medicare patients

As the Community Impact reports, the ER Elite Care 24 Hour Administrator Richard Burton declared that they have always seen Medicaid and Medicare patients regardless of ability to pay, said. But he said Elite Care is now expecting an increase in patients as a result of the change.

The possibility that this could affect staffing is very little. This might mean we have to bring out one more person. Burton said more patients will be able to take advantage of Elite Care’s quicker appointment turnaround and lower patient volume, as compared to area hospitals. The ER Elite Care 24 Hour sees around 3,000 patients every year, he reported.

Medicaid and Medicare in Texas: What’s next?

Brad Shields said they are working with the State Health Department. They are waiting for their Medicare billing numbers to be issued to them for being able to submit claims to Medicare. As Dr Shield said, NAFEC will continue working with CMS to make freestanding ERs a permanent option for Medicaid and Medicare patients, Shields said. The association will also work with the U.S. House of Representatives and the Senate for a federal statutory fix to update the Social Security Act.

Dr Shield states: “It’s important now during the pandemic, but it’s also going to be important long-term when we’re not in a public health emergency.” In the meanwhile, Elite Care has applied for the Medicare and Medicaid licensing and hopes CMS’s change can continue beyond the pandemic, Dr Burton said.

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