Washington state is preparing to limit Medicaid coverage of emergency room visits for non-emergency care, hoping to save millions of dollars each year.

State officials have notified clients that they will get coverage for only three of those visits each year starting Saturday. Additional visits will not be covered, and patients may be billed for that care.

"Non-emergency" ailments, according to the state, include everything from blisters to headaches to chest pain.

Supporters tout the cost savings, while critics argue the new restriction will force patients to try to diagnose themselves before getting needed medical help.

"This is a realistic strategy to change clients' behavior and improve patient care as well as assure taxpayers that we are addressing the state's continuing financial crisis," said Doug Porter, director of the state Health Care Authority, in a statement.

The Legislature has estimated that the state could save $35 million a year under the new limits.

Advocates are concerned that the state's list of non-emergency ailments includes conditions that need emergency attention, such as chest pain, nonspecific congestive heart failure and kidney stones. The Washington Chapter of the American College of Emergency Physicians said the policy will put people's health at risk and make the state vulnerable to lawsuits.

Dr. Stephen Anderson, president of the group's state chapter, told the Tacoma News-Tribune that the rules send the wrong message.

"Do (patients) know the difference necessarily between heartburn, heart attack, a blood clot in my lungs and a sore rib?" he asked. "These people shouldn't be sitting at home trying to self-diagnose."

Other less controversial ailments on the list of 700 include sunburns and insect bites.

Dr. Jeffery Thompson, Medicaid's chief medical officer, said providers and clients should recognize that some conditions would be better handled by primary care providers. He said about 97 percent of clients can live comfortably within the three-visit limit.

"The small number who exceed that limit are responsible for scores of visits - and most of them are for chronic conditions and complaints of pain - visits that usually end with a narcotics script," he said in a statement.

Clients have three visits to use until June 2012 before the count resets.

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Information from: The News Tribune, http://www.thenewstribune.com