Fair Payment for Emergency Department Services

Revised June 2023, June 2022, April 2016
Originally approved April 2009

Emergency physicians provide emergency medical services without regard for the patient’s insurance status or ability to pay, consistent with our mission and EMTALA obligations. Emergency physicians face unique financial challenges in meeting this mission. Emergency physicians play an important role in the health care safety net and continue to provide essential health care services to a disproportionate share of the uninsured and under-insured population in the United States. Fair payment for emergency care services, whether government funded, commercially insured, and/or paid by the patient must be sufficient to preserve the nation’s fragile emergency care safety net, and ensure that all patients have continued access to qualified emergency physicians. Federal and state regulatory boards should prohibit the practice of automatic denials and down coding of emergency department claims through the use of restrictive diagnosis lists, non-validated commercial algorithms, leveling policies, and other denial practices.