This article is a section taken from Emergency Medical Assistance (EMA), a part of the revisions and additions to the Minnesota Health Care Program Eligibility Policy Manual.
EMA Health Care Delivery
Emergency Medical Assistance (EMA) enrollees must follow guidelines for receiving medically necessary services. People who receive EMA are excluded from managed care enrollment. EMA medical services are provided via fee for service.
Fee for Service
Fee-for-service is a method of payment where the medical provider bills the Minnesota Health Care Programs (MHCP) for specific, individual services. Enrollees must use a medical provider enrolled with MHCP, except in special circumstances. A directory of enrolled providers is available online.
EMA covers the care and treatment of emergency medical conditions provided in an emergency department (ED) or in an inpatient hospital when the admission is the result of an ED admission. Emergency medical conditions include labor and delivery.
In certain situations, EMA may cover additional services when a health care provider determines additional services are needed to prevent serious jeopardy to the person’s health, or bodily impairment or dysfunction. EMA will cover these services only if they are part of an approved Care Plan Certification (CPC) (DHS-3642) request. The person’s provider must initiate the CPC request.
See the EMA section of the MHCP Provider Manual for more information on covered services.
Code of Federal Regulations, title 42, section 435.139
Code of Federal Regulations, title 42, section 435.350
Code of Federal Regulations, title 42, section 440.255
Minnesota Statutes, section 256B.06, subdivision 4
Minnesota Statutes, section 256B.0625, subdivision 4
CREDIT: The content of this post has been copied or adopted from the Minnesota Healthcare Programs Eligibility Policy Manual, originally published by the Minnesota Department of Human Services.
This is also part of a series of posts on Minnesota Healthcare Eligibility Policies.