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Position Statement on the Prudent Layperson Standard

AAEM/RSA opposes any legislation or practice that weakens the existing “prudent layperson” standard for defining an emergency medical condition, which requires health insurance plans to base reimbursement on a patient’s presenting complaint rather than the final diagnosis. Emergency departments cannot preserve the nation’s safety net of medical care if the “prudent layperson” standard is allowed to disappear. Therefore, AAEM/RSA supports strengthening protections for the “prudent layperson” standard to prevent states and insurers from either blatantly ignoring the standard, or passing legislation that allows for waiver of the protections it affords patients, insured and uninsured alike.

 

Approved April 9, 2018