Emergency Department Boarding Update
Addressing long wait-periods for people with acute mental illness or substance use disorder emergencies
Recent media have been reporting about the long wait-periods people with acute mental illness or substance use disorder endure in Emergency Departments before they are admitted for care. Tufts Health Plan recognizes this as an important issue to be addressed. In January, the Massachusetts Division of Insurance took action.
The Massachusetts Division of Insurance (DOI), Department of Mental Health (DMH) and Department of Public Health (DPH) jointly issued a bulletin to commercial health plans regarding the prevention of Emergency Department (ED) “boarding” of patients with acute behavioral health and/or substance use disorder emergencies.
ED boarding occurs when a patient comes to the ED and it is determined that inpatient services are necessary, but a bed is not immediately available. The patient remains in the ED or on a patient floor until a bed becomes available. Effective February 1, 2018, health care facilities are required to send an alert to the member’s health insurance carrier if the member has been in the ED for a period of 24 hours awaiting placement in an inpatient psychiatric facility. And if after 48 hours, if the member still has not been placed, facilities are required to send the member’s health insurance carrier a request for assistance via fax or phone. The health insurance carrier must then work closely with the ED to assist with placement. If after 96 hours the member still has not been placed, the health insurance carrier must notify DMH and request assistance.
Tufts Health Plan adheres to the rules and regulations outlined in this bulletin, which applies to all fully insured Commercial plans. For more information, visit the DMH website.
We are committed to helping our members get and stay healthy.