Case Studies

TCEP Leadership and Advocacy Fellowship
An overview of the Texas chapter's program that has successfully developed future chapter leaders and provided them with opportunities to learn about and become active in the advocacy arena.

Admission of Psychiatric Patients Case Study
Psychiatric patients deemed dangerous by the emergency physician could not be admitted to psychiatric units without certification of coverage by managed care organization (MCO) reviewers. Reviewers would often delay or deny coverage.

Assault on Emergency Medical Personnel Case Study
Violence against emergency department (ED) personnel while at work.

Building a Motorcycle Helmet Safety Coalition: The Pennsylvania Experience Case Study
Repeal of Pennsylvania's 30-year-old all-rider motorcycle helmet law has been an objective of a group of vocal and persistent motorcyclists that includes the Alliance of Bikers Aimed Towards Education (ABATE), the national organization of cyclists dedicated to repealing helmet laws.

Definition of Emergency Services Case Study
Retrospective denial of payment by insurance companies, health maintenance organizations (HMOs), and managed care plans for emergency services rendered to patients, based on final diagnosis rather than the presenting complaint.

Do Not Attempt Resuscitation Orders in Prehospital Care Case Study
Inappropriate resuscitation of terminally ill patients.

Ensuring Adequate Medicaid Reimbursement: The Michigan Experience 
Michigan physicians had been chronically underpaid for providing professional services to Medicaid beneficiaries for years, and indeed had not had a raise in fees since 1989. As a result, access to primary care services for Medicaid recipients was compromised, forcing more of them to seek such care in the ED.

Fragmenting Bullets Case Study
General public's access to armor piercing and plastic polymer bullets, which fragment on impact.

Funding for Emergency Medicine Residency Programs Case Study
Graduate medical education and funding for emergency medicine residency programs.

HMO Preauthorization Requirements (COBRA Reconciliation Act) Case Study
Calling health maintenance organizations (HMOs) for authorization to provide care in the ED is dangerous to ill patients, burdensome to ED providers, time-consuming, and potentially in conflict with (COBRA/EMTALA) regulations.

How Prudent Layperson Legislative Advocacy Helped Build a Stronger Chapter Case Study
In 1993, Maryland became the first state to enact the prudent layperson standard of access to emergency medical care Since then, state lawmakers have continued to examine how managed care plans should reimburse for emergency care services.

Managed Care Organizations and Emergency Medical Care – The California Experience Case Study
Inappropriate retrospective denial of emergency care claims by managed care organizations (MCOs) based on lack of preauthorization or review of final diagnosis instead of presenting complaint.

Managed Care Organizations and Emergency Medical Care – The Florida Experience Case Study
Managed care organizations (MCOs) and emergency medical care.

Per Se Blood Alcohol Concentration and Motor Vehicle Safety Case Study
Enacting and enforcing state legislation to prohibit alcohol-impaired driving by mandating that a blood alcohol concentration (BAC) of 0.08 g/dL is per se evidence of driving while impaired.

State Medicaid Physician Reimbursement – Working with State Policy Makers Case Study
Increasing physician reimbursement, whether for Medicaid or any other service or program, is a touchy, difficult issue to lobby.

Tort Reform Case Study
Comprehensive reform of Texas' civil justice system.

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