MUST Act of 2007

Many thanks to Aggravated Doc Surg for bringing this to my attention.  I thought I was the only one with this idea, but clearly I’m not:

To my surprise, Congresswoman Mary Bono (the late Sonny’s wife) recently introduced a bill that would alter IRS rules to allow physicians to at least partially offset the cost of providing uncompensated emergency care mandated by EMTALA.

And goes on to quote parts of the bill (.pdf). 

There are things to quibble about in this first draft; none are deal-breakers, but they should be modified to some degree.  First is the “Board Certification” requirement: unless this is required by HCFA, it should be ‘credentialled provider in the Emergency Department’, and we can all avoid a food fight about Board Certification that serves only divisiveness.

Second, while basing any tax allowance on the Medicare fee schedule is a good place to start, I’m not sure we should aim that low.  Every ED has a payor mix that’s at least somewhat above the medicare allowable; I’d prefer a calculation that takes that into account, so we’re not taking a tax allowance at 50 cents on the dollar, rather than a higher number that’s usual in most ED’s.  (I know it’s not dollar for dollar, but it’s higher than the medicare allowable rate).

Congresswoman Bono is to be congratulated for at least introducing this legislation.  I hope our EM professional societies see fit to support it as possible: the American College of Surgeons is already onboard.


  1. Just the ER doc says:

    Why does neither ACEP or AAEM have any mention of this on their websites?

  2. NEMPAC donated a good sum of money to Representative Bono in 2006.

    It would be nice to see ACEP/AAEM publicly promote the bill.

  3. Interesting — check out my blog entry from January 29th suggesting the same thing. Have to find it yourself since I do not wish to offend anyone with a link.

  4. NoAcuteDistress says:

    Does this bill have any provision for recompensing CONSULTANTS who are called in on those same non-paying patients which EMTALA has forced us all to see?

  5. Read the bill. Page 3, lines 8 – 14.