On Thursday, the Senate voted 90-2 to extend the current moratorium on the 2 percent Medicare sequester, preventing cuts to emergency physicians and other health care professionals that were scheduled to go into effect on April 1.
The version of H.R. 1868 passed by the Senate extends the sequester moratorium through the end of 2021, but was amended to remove the provision waiving the statutory PAYGO waiver needed to avoid an additional 4 percent sequester in the beginning of 2022. As the legislation was amended by the Senate, it requires an additional vote in the House of Representatives before it heads to President Biden's desk for his signature into law.
ACEP strongly supported this effort to avoid devastating cuts to Medicare reimbursements, especially as emergency physicians continue working tirelessly to respond to the COVID-19 pandemic. Though the more immediate threat of Medicare cuts has been averted, ACEP continues working with legislators to address the potential 4 percent statutory PAYGO sequester cuts slated for 2022.
On Wednesday, the ACEP-supported "Workplace Violence Prevention for Health Care and Social Service Workers Act" (H.R. 1195), sponsored by Rep. Joe Courtney (D-CT) was approved in a bipartisan vote during markup in the House Committee on Education and Labor. This legislation directs the Occupational Safety and Health Administration (OSHA) to require employers to establish workplace violence prevention standards and plans to protect emergency physicians, nurses, and other health care workers from violence and assaults at work.
During the markup, Rep. Courtney cited results from a 2018 ACEP survey of more than 3,500 emergency physicians which found that nearly half reported having been physically assaulted at work, and also specifically noted ACEP's letter of support for the legislation. ACEP also supported a previous version of this bill introduced and passed by the House of Representatives in the 116th Congress, but was not considered by the Senate before the end of the session.
Approved by the full committee, the bill now awaits consideration by the full House of Representatives. ACEP continues working closely with Rep. Courtney to ensure this legislation is brought to the House floor in the near future.
On Tuesday, the Senate Committee on the Judiciary held a hearing, titled "Constitutional and Common Sense Steps to Reduce Gun Violence". The hearing came shortly after mass shootings in Georgia and Colorado that claimed the lives of eight and ten people.
The sometimes contentious hearing resulted in accusations of partisanship and "political theater", as well as calls for the Senate to pass legislation to reform the nation's firearms laws. ACEP submitted a statement for the record outlining ACEP's "Firearms Safety and Injury Prevention" policy and the various legislative proposals supported by ACEP to provide commonsense reforms to the nation's firearms laws.
Given the 50-50 party split, it appears unlikely that the Senate will be able to reach consensus on any firearms-related policy reforms, including H.R. 8, the "Bipartisan Background Checks Expansion Act" recently passed by the House of Representatives.
On Thursday, the Senate Health, Education, Labor & Pensions (HELP) Committee held a hearing entitled, "Examining Our COVID-19 Response: Improving Health Equity and Outcomes by Addressing Health Disparities". Witnesses included Consuelo Wilkins, MD, MSCI, Vice President for Health Equity at Vanderbilt University Medical Center; Abigail Echo-Hawk, Executive Vice President of the Seattle Indian Health Board; Taryn Mackenzie Williams, Managing Director, Poverty to Prosperity at the Center for American Progress; and Gene Woods, President and CEO of Altrium Health.
The hearing was dominated by bipartisan support for increased data and public health surveillance efforts to identify the impact of COVID-19 on different populations, improve access for rural and minority populations, and increase the use of telehealth among underserved communities. Democratic Senators emphasized the need to increase access and services, particularly to individuals in Native American populations, minority groups, and people living with disabilities, and address underlying racism. Republican Senators focused on initiatives to make technology more accessible to populations that lack broadband and face other barriers to the use of telehealth services.
To view the hearing, click here. To read ACEP's letter submitted for the record, click here.
On Tuesday evening, the U.S. Senate voted 57 to 43 to confirm Vivek Murthy, MD, (again) as Surgeon General of the United States making him the 19th and 21st person to serve in that role.
The following day, the U.S. Senate voted 52 to 48 to confirm Rachel Levine, MD, as HHS Assistant Secretary of Health.
Last week, we referred you to the ACEP Advocacy Action Center to find and communicate with your elected officials. This week, we encourage you to use social media to amplify your advocacy on behalf of emergency medicine.
Stay in the know! Follow ACEP on Twitter and Facebook for news, education, and advocacy updates for ACEP members. Follow Emergency Docs on Twitter and Facebook for public and advocacy updates, and news for emergency physicians and patients.
Be sure to tag @EmergencyDocs, our channel for the public and policymakers, when posting and reaching out to your legislators on Twitter and Facebook.
Use and follow #ACEPAdvocacy on Twitter. You can also use issue specific hashtags such as #StopEDViolence #LornaBreenAct
You can like and share our posts on advocacy issues, comment, retweet, tag your colleagues or your ACEP Chapter, and tag your legislators to get the word out!
If you are reaching out to your legislators about an issue, such as an action alert, consider using social media as well. You can look up their information under "Find Officials" in the Advocacy Action Center or in this list of 117th Congress twitter handles.
You can also use social media to introduce yourself, follow up after a meeting, and thank your legislators for their support on an issue.
Pictures make posts more engaging! Consider sharing a selfie in your PPE, photo of your virtual meeting (if you ask for their permission), or a photo from a previous meeting if you are tagging a member of Congress you have met before.
Check out the NEMPAC 2020 Election Cycle Report to learn more about NEMPAC's candidate criteria in 2019 and 2020, the incumbents and candidates we supported, our legislative accomplishments in the 116th Congress, how we pivoted during the pandemic, and recognition of the many ACEP members who are generously supporting our efforts.
See how NEMPAC impacted elections across the country and helped elect pro-emergency medicine candidates to Congress.
Click here to read the report.
As a reminder, this report covers the time period of January 1, 2019 through December 31, 2020.
On Wednesday, ACEP and the Emergency Department Practice Management Association (EDPMA) sent a letter to federal agencies that outlines our policy recommendations for implementing the "No Surprises Act". The "No Surprises Act", which was enacted as part of a larger comprehensive COVID-19 relief bill at the end of last year, bans balance billing for out-of-network (OON) services starting in 2022 and establishes a back-stop independent dispute resolution (IDR) process to ensure that clinicians and facilities are paid appropriately for the OON services they deliver.
As background, for the last two years, ACEP has advocated on behalf of emergency physicians and patients to ensure that any legislation that would address surprise medical billing (SMB) would truly keep patients out of the middle of billing disputes and include a fair payment mechanism that would hold health plans accountable and ensure adequate reimbursement for OON services. We believe that the "No Surprises Act" represents a reasonable solution to this issue, given how damaging initial congressional proposals would have been for emergency physicians.
Like any major piece of the legislation, the details of the "No Surprises Act" need to be hammered out through the regulatory process. To help us comb through the SMB legislation and develop a well-rounded advocacy strategy for the regulatory process, ACEP teamed up with EDPMA to form a joint task force. Together, ACEP and EDPMA will ensure that the message from the emergency medicine community is loud, clear, consistent, and timely.
The letter submitted to federal agencies this week encompasses feedback from this EM SMB Implementation Task Force. It is broken out into the following six sections:
Overview and Perspective: Unique aspects of emergency care.
Important Definitions: "qualifying payment amount", "recognized amount", "initial payment", "denial of payment", and audits for plan calculations.
Federal/State Law Interaction: Providing recommendations on how the "No Surprises Act" should interact with new or existing state laws.
Independent Dispute Resolution (IDR) Process: Proposing recommendations for the implementation of the federal IDR process.
Administrative Processes: Providing suggestions for specific billing and other administrative processes.
State APCDs: Providing recommendation for health plan reporting requirements when submitting data to state all-payer claims databases (APCDs).
ACEP and EDPMA have requested a joint meeting with the Center for Consumer Information and Insurance Oversight (CCIIO-one of the main agencies implementing the law) and are hoping to engage further with them on our recommendations.
The "21st Century Cures Act", a monumental law enacted in 2016, included numerous new requirements around the access, exchange, and use of patients' electronic health information (EHI). The intent of the law is to prevent and eliminate wide-spread "information blocking"-the practice of withholding patients' data or knowingly making it difficult or impossible to exchange data between electronic health record (EHR) systems. The Office of the National Coordinator (ONC) for Health Information Technology with the U.S. Department of Health and Human Services (HHS) issued a regulation implementing the information blocking provisions of the "21st Century Cures Act" last year (ACEP's comments on the proposed rule can be found here).
In the rule, ONC describes in detail new requirements that health care practitioners, including you as emergency physicians, must take around data sharing. While these new data sharing mandates were originally scheduled to go into effect last November, they were delayed until April 5 of this year due to COVID-19. When they do go into effect, all of you will be required to make your patients' EHI available for access, exchange, and use.
With April 5 just around the corner, read the Regs & Eggs blog for some high-level information about the requirements and what they mean for you. The blog also includes some additional resources that you can review if you want to dig into the details.
