A snapshot of Georgia: Emergency Medical Assistance, a program of the Georgia Department of Community Health [July 2008]

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 2008 (May 2008)

Time Period

Patients

Net Payment

FY 2003

19,630

$70,706,792.00

FY 2004

25,641

$94,532,840.36

FY 2005

28,031

$109,534,993.90

FY 2006

26,387

$106,096,164.60

Definition of an Emergency

FY 2007 FY 08 ytd

22,205 19,152

$83,676,954.32 $66,960,100.82

An emergency is defined as the onset acute

symptoms of sufficient severity such that the absence of immediate medical attention could result

FY 2008 Expenditures for Emergency Medical Assistance Pregnancy Deliveries Only*

in: nPlacing the patient's health in serious jeopardy;

Fiscal Year FY 2008 ytd

Patients 12,671

Net Payment $41,480,693.90

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 federal definition. Care and

services can not be related to an organ transplant procedure or routine prenatal or

postpartum care.

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

July 2008