[NIFL-HEALTH:3966] RE: help with "prudent layperson" explanation

From: Kirsten Aspengren (kaspengren@cfhnyc.org)
Date: Mon Apr 28 2003 - 17:39:08 EDT


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From: "Kirsten Aspengren" <kaspengren@cfhnyc.org>
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Subject: [NIFL-HEALTH:3966] RE: help with "prudent layperson" explanation
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I am sorry that I do not have a definition blessed by CMS, but I would love to see the handbook when you're finished.  Is it possible to share it with the group?
Good Luck
Kirsten

Kirsten L. Aspengren
Health Policy Coordinator
Care for the Homeless
12 West 21st Street, 8th Floor
New York, NY 10010
Phone (212) 366-4459
Fax (212) 366-1773
kaspengren@cfhnyc.org


-----Original Message-----
From: Janet Sorensen [mailto:Jsorensen@afmc.org]
Sent: Monday, April 28, 2003 5:26 PM
To: Multiple recipients of list
Subject: [NIFL-HEALTH:3965] help with "prudent layperson" explanation


I recently changed addresses and have not been reading my list messages, so
forgive me if this has already been covered or if it is an inappropriate
request.
I'm struggling against a deadline to revise our handbook for Medicaid and
CAHPS program recipients. I'm trying to get it down to a fourth- or
fifth-grade reading level whenever possible. But the Centers for Medicare &
Medicaid Services says we must include certain things, such as the "prudent
layperson" definition of an emergency. I might have to include the federal
wording (ugh) but I'd like to put it in quotation marks and then follow it
with some kind of simpler explanation--which of course would have to be
approved by CMS as well. I'm wondering if a simpler explanation already
exists that has already been blessed by CMS. I have had no luck so far
searching on the Web.

Here is the federal definition, just so you'll know what I'm talking about.
I can take a stab at simplifying it but getting it approved will probably be
a challenge.

"The term 'emergency medical condition' means a medical condition
manifesting itself by acute symptoms of sufficient severity (including
severe pain) such that a prudent layperson, who possesses an average
knowledge of health and medicine, could reasonably expect the absence of
immediate medical attention to result in --
(i) placing the health of the individual (or, with respect to a pregnant
woman, the health of the woman and her unborn child) in serious jeopardy,
(ii) serious impairment to bodily functions, or
(iii) serious dysfunction of any bodily organ or part."

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