A Program Of The Georgia Department Of Community Health
A SNAPSHOT OF GEORGIA
Emergency medical assistance
Overview
Emergency Medical Assistance (EMA) is a federally mandated program which provides medical coverage to individuals who meet all requirements for a Medicaid Class of Assistance (COA) except for citizenship requirements, and who have received an emergency medical service.
Program Description
EMA covers persons who are ineligible for Medicaid due to not being United States citizens or other reasons. This population could include immigrants who are aged, blind, disabled, pregnant women, children, or parents with dependent children.
These persons may apply to get assistance to pay bills that were incurred due to a medical emergency. EMA is not an ongoing coverage plan. Applicants must apply for this service as each medical emergency is incurred. In addition, EMA may not pay all expenses for care, since it only covers the care that treats the immediate emergency.
Annual Expenditures for Emergency Medical Assistance
FY 2002 - FY 2006
Fiscal Year Unique Patients Net Payment
FY 2002
15,469
$64,557,192.31
PMPY1 $4,173
Definition of an Emergency
FY 2003 FY 2004
18,207 20,459
$80,830,902.24 $97,765,823.67
$4,440 $4,779
An emergency is defined as the onset acute symptoms of sufficient severity such that the
FY 2005
24,029
$117,529,369.75 $4,891
absence of immediate medical attention could result
FY 2006
22,600
$99,725,624.54 $4,413
in:
1PMPY stands for Per Member Per Year
nPlacing the patient's health in serious
jeopardy;
nSerious impairment to bodily functions; or nSerious dysfunction of any bodily organ or part. In addition, all labor and delivery is considered an emergency by
FY 2006 Expenditures for Emergency Medical Assistance
Pregnancy Deliveries Only
federal definition. Care and services can not be related to an organ transplant procedure or routine prenatal or postpartum
Fiscal Year
Patients Net Payment
FY 2006
17,055
$71,249,174
Member Eligibility
A Medicaid Eligibility worker will review an application to determine if the client is eligible for a Medicaid COA. If a person is eligible for COA but not a citizen, he may be eligible to receive EMA. The clinical information is then reviewed by an external clinical review organization to determine whether the care was emergent, before a final decision is made.
2 Peachtree Street, Atlanta, Ga 30303 w www.dch.georgia.gov
February 2007
A Snapshot Of Emergency Medical Assistance