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Bush Administration Rescinds Medicaid ER Policy

WASHINGTON -- Under fire from critics, the Bush administration Wednesday canceled a policy put in place last month that would have allowed states to place limits on emergency care for Medicaid patients.

"Due to the concerns we heard from you and others, the will be notifying states that we are rescinding the December 20 letter and that the previous guidance is to be followed," CMS Administrator Tom Scully wrote in a letter to members of the US Senate Finance Committee. Scully met with the Senators and their staff on Tuesday to hear their complaints about the policy.

Scully had defended the policy only hours before it was reversed. Speaking at the National Health Policy Conference, Scully said he thought the policy allowing states to impose limits on emergency room care for Medicaid patients in managed care plans "was pretty well thought out."

Scully also denied that the policy would hurt patients. "The patient still has to be treated," he said, noting that another federal law, known as EMTALA, requires hospitals that get Medicare or Medicaid funding to at least examine any patient who shows up asking for emergency room care. "We're just trying to give states more flexibility," he added.

But the letter issued Wednesday afternoon noted that "the policy, while well-intentioned, may have some unintended consequences and could potentially result in some restriction of payment for true emergency care for Medicaid beneficiaries." Scully said he intends to work with senators in the future "on policies to discourage the inappropriate use of emergency room care."

Separately, Scully at the policy conference again urged Congress to act as soon as possible to block a 4.4% fee cut for physicians serving Medicare patients. That cut is now set for March 1.

"It's not good for doctors or patients," he said, if the cut takes effect, because many physicians have warned they may stop seeing Medicare beneficiaries.

Meanwhile, FDA Commissioner Mark McClellan, who also addressed the conference, reiterated his agency's opposition to efforts to make it easier for consumers to buy drugs from Canada at that country's lower prices.

"We really do view this as a potentially important safety risk," said McClellan. "Reimported drugs are not reliably safe and effective." Nevertheless, he acknowledged that prices are often much cheaper across the border, and he said he expects Congress to continue to debate the issue.

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