Emergency Medical Assistance 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.

Covered Services

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.

Legal Citations

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