Freestanding ER To See Medicare and Medicaid Patients


CMS announced on April 21st that freestanding Emergency Rooms (ER) in Texas, Colorado, Delaware, and Rhode Island have been temporarily approved to see Medicare and Medicaid enrollees to help reduce pressure seen on hospitals treating COVID-19 patients. Usually, federal regulations do not allow a freestanding ER to bill Medicare and Medicaid patients for services unless they are affiliated with a hospital in some way. Any freestanding ER that wants to participate in the Medicare and Medicaid program must either: become affiliated with Medicare/Medicaid-certified hospital under the temporary expansion 1135 emergency waiver; participating in Medicaid under the clinic benefit if permitted by the state, or enrolling temporarily as a Medicare/Medicaid-certified hospital to provide hospital services.

CMS Approved Freestanding ER

A freestanding ER, although sometimes known as money grabbers, can be beneficial especially with the treating and testing going on for those with COVID-19. Seema Verma, the administrator of the Centers for Medicare & Medicaid Service (CMS), said in a written statement “Expanding the number of providers available to Medicare and Medicaid beneficiaries eases some of the burden shouldered by traditional hospitals and allows the healthcare system to treat more patients at a time when capacity is often limited”. Now with the temporary approval from CMS, freestanding ERs across Texas, Colorado, Delaware, and Rhode Island will be able to help with COVID-19 response. These new regulations add on to the multiple new waivers that have been passed to allow health care providers the ability to be more flexible when responding to the pandemic. Texas Emergency Care Centers CEO Rhonda Sandel believes these new approvals and recognitions from CMS patients will feel more welcomed going into freestanding facilities during the COVID-19 outbreak. “This temporary recognition will enable the emergency doctors, nurses, and staff, to be fully utilized during our current health crisis and care for the country’s most vulnerable community”.

What do you think about freestanding ERs taking Medicare and Medicaid enrollees? Would you feel comfortable going to one during these times if necessary? Leave your comments below and tell us how you feel about the CMS announcement!

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