Insurance Policy Change Prompts Response from ACEP

 

American College of Emergency Physicians pic
American College of Emergency Physicians
Image: acep.org

Emergency room physician Dr. Kenneth (Ken) Mwatha received his medical training at Johns Hopkins University. Currently employed in Baltimore, Dr. Ken Mwatha manages a busy emergency department, treats patients for a wide variety of medical conditions, stabilizes critically ill patients, and performs lifesaving procedures on trauma patients. Dr. Mwatha is a member of the American College of Emergency Physicians (ACEP).

The organization recently launched a campaign in response to a large insurer’s decision to deny emergency coverage for patients who receive a diagnosis that is later determined not to be an emergency.

Indianapolis based Anthem Blue Cross Blue Shield recently initiated a policy that denies coverage of emergency medical treatment that is administered in a non-emergency situation. The American College of Emergency Physicians has reacted to the shift by initiating a campaign that highlights the flaws of the insurer’s policy. The group’s videos highlight patients who are experiencing symptoms but are unsure if emergency treatment is needed. Because they fear a potentially high emergency room bill, they forego treatment and risk severe consequences.

The American College of Emergency Physicians argues that patients with no medical training should not be expected to discern whether their symptoms constitute an emergency. They also point out that the policy is a violation of a federal law known as the prudent layperson standard, which requires insurance companies to determine coverage based on a patient’s symptoms rather than a diagnosis.

In response to the national outcry over the new policy, Anthem Blue Cross Blue Shield has adopted exceptions that include physician advised visits to the emergency room, children under the age of 15, people who are traveling out of state, and patients who have recently undergone surgery or received medicines or IV fluids.

Advertisements

ACEP Invites Emergency Physicians to 2017 Leadership Conference

American College of Emergency Physicians pic
American College of Emergency Physicians
Image: acep.org

Since 2013, Dr. Kenneth “Ken” Mwatha has served as an attending physician in the Department of Emergency Medicine at Baltimore’s St. Agnes Hospital. Alongside his day-to-day professional activities, Dr. Ken Mwatha maintains a membership in the American College of Emergency Physicians (ACEP).

Throughout the year, ACEP oversees a variety of programs and events aimed at education, research, and advocacy. Currently, the organization is preparing to host its 2017 Leadership and Advocacy Conference at the Grand Hyatt Washington in Washington, D.C. The event, which will take place March 12-15, will include sessions focused on health policy and the key issues that are currently affecting emergency medicine.

In addition to featuring educational sessions led by expert faculty and panels, the conference will give attendees the opportunity to visit Capitol Hill to meet with members of Congress and other key decision-makers. Both ACEP members and non-members are invited to attend the event to sharpen their advocacy and leadership skills while helping to promote their profession. For more information about the event, visit www.acep.org.

American College of Emergency Physicians Award Ceremony

American College of Emergency Physicians pic
American College of Emergency Physicians
Image: acep.org

Ken Mwatha serves as an attending physician of emergency medicine in a Baltimore, Maryland hospital. When he is not assisting patients, Ken Mwatha stays involved with professional organizations in his field, including the American College of Emergency Physicians.

The American College of Emergency Physicians began in 1968, when a small group of doctors decided they wanted to set a higher standard for emergency care. They set out to train other physicians in how to provide quality care in this challenging setting. In 1979, emergency medicine became recognized as a specialty in the medical field.

In October of 2016, the American College of Emergency Physicians held a ceremony at its annual meeting in Las Vegas, Nevada, that honored contributions and changes made in emergency medicine. Various awards were presented to recognize accomplishments in research, advocacy within the field, education, and quality of care. In addition, the organization granted honorary memberships to various professionals within the discipline.