Medicaid is notifying clients that it is changing coverage for some health care services as a consequence of budget reductions for the 2011- 2013 biennium. A letter is being mailed to clients on September 1, 2011. It details benefit changes that became effective July 1, 2011, as well as others that will take effect on October 1, including a new three-visit limit on non-emergency treatment athospital emergency rooms.
· A list of diagnosis codes the Agency considers to be non-emergency will be posted in mid-September on the Billing Instructions site. When a client is seen atthe ER and the principal diagnosis is on the non-emergency diagnosis list the visit will be classified as a non-emergency visit to the ER. Each client will be allowed three such visits in the fiscal year ( July – June) starting October 1, 2011.
· Please note: The three-visit limit to using emergency rooms for non-emergency reasons does not apply to Medicaid foster children.