CMS OKs streamlined Medicaid admissions in Calif.
The CMS has given California permission to ease the hospital admission process for patients in the Medicaid fee-for-service program.
Under a new waiver, the state will launch a two-year process for hospitals to voluntarily transition to a more streamlined way of admitting patients. Currently, all hospitals, except for public safety net hospitals, have to get preauthorization before admitting fee-for-service Medicaid patients. Now, hospitals will be able to skip pre-authorization and instead follow national clinical guidelines for determining whether a patient should be hospitalized.
To start, 11 hospitals will receive education and training starting in early 2016, according to Jan Emerson-Shea, a California Hospital Association spokeswoman. The state intends to have all hospitals using the new process by 2018. “This should save time and money for both hospitals and the state,” Emerson-Shea said.
Dr. Jay Kaplan, a California emergency physician who is president-elect of the American College of Emergency Physicians, said faster admissions can save lives. “We know the quicker we get them into a bed, the better the outcome,” he said.
As many as 3 million California Medicaid beneficiaries are still in the fee-for-service program, according to the state. They include people who are dually eligible for Medicaid and Medicare, and residents of long-term-care facilities.