Come together with your emergency medicine colleagues in person in Washington, DC for the ACEP Leadership & Advocacy Conference (LAC) from May 1-3, 2022. Celebrate emergency medicine's accomplishments and continue to work for a better political environment for your specialty and your patients. First-timers to the conference will be trained to educate Members of Congress while seasoned participants will build upon their already-valuable Congressional connections.

Highlights include a Health Policy Primer sponsored by EMRA; Leadership Summit featuring emergency physician experts addressing topics such as Physician Burnout, ED Violence, Physician Collective Action, and Scope Battles in the States: and comprehensive advocacy and issue training to prepare for visits with legislators on Capitol Hill. Confirmed government and congressional speakers include Admiral Rachel Levine, Assistant Secretary for Health (ASH), Sen. Tim Kaine (D-VA), and Sen. Tammy Baldwin (D-WI). Additional opportunities will be offered to interact directly with legislators during the NEMPAC dine-arounds with confirmed participants Rep. Larry Bucshon, MD (R-IN), Rep Ami Bera, MD (D-CA), Sen. Tim Kaine (D-VA), and Rep. Richard Hudson (R-NC).

Barring any unforeseen circumstances, registrants will be traveling to Capitol Hill on the afternoon of May 3 for in-person meetings with legislators and their staff. Click here for more information and to register.

On Wednesday, the Senate Committee on Homeland Security and Governmental Affairs (HSGAC) passed the bipartisan, ACEP-supported "Post-Disaster Mental Health Response Act," (S. 3677) sponsored by Reps. Dick Durbin (D-IL) and Rob Portman (R-OH). The legislation expands federally funded mental health resources and assistance through the Federal Emergency Management Agency's (FEMA) Crisis Counseling Assistance and Training Program (CCP).

The CCP provides guidance, tools, funding, and best practices to help communities recover from the mental health impacts of disasters, using evidence-based counseling interventions to help individuals in the short term and connecting survivors, including first responders and frontline providers, and others with appropriate long-term care options they need. However, these resources are currently only available to communities that have experienced a Major Disaster Declaration, and not for those that have received smaller-scale Emergency Declarations. This legislation will extend the reach of the CCP, ensuring that state and local governments can access the mental health support and resources for communities that have experienced disasters and received Emergency Declarations.

On Wednesday, the Senate Committee on Finance held a hearing, entitled "Behavioral Health Care When Americans Need It: Ensuring Parity and Care Integration." The bipartisan hearing featured significant agreement between both sides of the aisle, with members reiterating their intent to put forward a mental health legislative package this year.

The focus of the hearing was on the issue of mental health parity laws and how despite these federal laws have been in the books for more than a decade now, insurers have continued to find ways to skirt or bypass mental health parity requirements. Chairman Wyden cited some of these bad insurer practices, including the use of "ghost networks" where patients are unable to get appointments through provider directories, unaffordable out-of-pocket costs, coverage limits, prior authorization, unpaid claims, and other barriers and burdens on patients experiencing mental health crisis.

The witness panel featured: John Dicken, Director, Health Care, U.S. Government Accountability Office (GAO); Andy Keller, Ph.D., President and CEO, Linda Perryman Evans Presidential Chair, Meadows Mental Health Policy Institute; Anna Ratzliff, MD, Ph.D., Co-Director of the Advancing Integrated Mental Health Solutions (AIMS) Center and Professor, University of Washington, Seattle, WA; and, Reginald D. Williams II, Vice President for International Health Policy and Practice Innovations, Commonwealth Fund.

The Federal Trade Commission (FTC) and Department of Justice need feedback on the guidelines for how they examine mergers, and your input could help tell the story of how emergency medicine has been affected.

Previously, the government guidelines for examining mergers have focused only on mergers' direct impact on competition, but wanting to modernize these guidelines, the FTC is exploring the effect mergers can have on labor conditions.

ACEP recently met with the FTC to share our thoughts on the impact of consolidation on emergency medicine, and we are now seeking examples from individual emergency physicians. If your practice was impacted recently by a merger or acquisition, or if you have been impacted, either positively or negatively, by mergers and acquisitions in emergency medicine, please share your story. You can respond anonymously, and no identifying information will be used in ACEP's response. Deadline for feedback is April 15.

Every year, the White House releases a Budget that serves as its official funding request to Congress for the following fiscal year (FY) that begins in October. And that is exactly what it is: a request. Congress can choose to accept some proposals, reject others, or simply use the Budget as a paper weight. It includes both funding requests for specific federal agencies that would be handled through Congress' appropriations process as well legislative proposals for Congress' authorizing Committees to consider. 

The President's Budget serves as an opportunity for the current Administration to display its priorities-to show Congress and the public what it really cares about and what it does not; what it is willing to invest in and what it is willing to cut. The FY 2023 President's Budget, released this past Monday, does mostly fulfill that purpose. It includes some significant, cross-cutting priorities that are extremely important topics on which to focus, such as addressing our country's mental health crisis. However, it fails to tackle some critical issues-which, one may argue, also makes the Budget a lost opportunity.

Read the Regs & Eggs blog to learn more about some of the priorities included in the Budget, along with one omission that the Administration probably should have addressed.

On Wednesday, the Biden Administration launched COVID.gov, a website to "help all people in the United States gain even better access to lifesaving tools like vaccines, tests, treatments, and masks, as well as get the latest updates on COVID-19 in their area." As part of COVID.gov, a new Test-to-Treat locator will help people access pharmacies and community health centers across the country where people can "get tested for COVID-19 and receive appropriate treatments if they need them." Test-to-Treat is now available for all Veterans Affairs (VA) patients in VA clinics and in more than 240 federally qualified health centers (FQHCs) and Indian Health Service (HIS) Facilities across the country.

This week, the Centers for Medicare & Medicaid Services (CMS) released the 2021-2030 National Health Expenditure (NHE) report that represents health spending and enrollment projections for the coming decade. The report finds that annual growth in national health spending is "expected to average 5.1% over 2021-2030, and to reach nearly $6.8 trillion by 2030." 
Some highlights in the NHE report include the following:  
• Medicare spending growth is projected to average 7.2% over 2021-2030; 
• Average annual growth of 5.6% is projected for Medicaid spending for 2021-2030; 
• Private health insurance spending growth is projected to average 5.7% for 2021-2030; 
• Hospital spending growth is projected to average 5.7% for 2021-2030; and
• Physician and clinical services spending is projected to grow an average of 5.6% per year over 2021-2030.

On Wednesday, ACEP responded to a proposed rule issued by the Department of Homeland Security (DHS) that would revise the "public charge" policy implemented by the previous administration. Federal law prohibits noncitizens from requesting admission to the United States or applying for lawful permanent residence from within the United States to be approved if they are to be a "public charge."

In 2019, the previous administration expanded the interpretation of the term "public charge" and the types of public benefits considered to include non-cash benefits, such as food stamps, Medicaid, and the Children's Health Insurance Program. At the time, ACEP opposed this policy, as we believed that it would cause fear and confusion among many legal immigrants-leading them to disenroll from essential programs and stop receiving benefits for which they are eligible. This fear unfortunately became a reality for many.

The Biden Administration is now proposing to narrow the definition of public charge to "likely to become primarily dependent on the government for subsistence." Under the rule, DHS would no longer consider as part of the definition of public charge noncash benefits such as food and nutrition assistance programs including food stamps, the Children's Health Insurance Program, most Medicaid benefits (except for long-term institutionalization at government expense), housing benefits, and transportation vouchers.

In our response, ACEP strongly supports the reversal of the 2019 public charge policy. We believe that it will reverse some of the uninsurance trends that we are seeing among this population as many immigrants are now declining to enroll in Medicaid and CHIP. We also state that it would alleviate the apprehension of non-citizens in going to the doctor, a result of the prior policy.

Last week, ACEP responded to a request for information issued by the White House Office of Science and Technology Policy (OSTP) on how to strengthen communities through the use of digital technologies.

In our response, ACEP discussed how telehealth was used by emergency physicians during the pandemic and outlined some of the existing regulatory barriers to the continued use of digital technology. We also stated that telehealth may not be an effective tool by itself to reduce health care disparities. There are many structural barriers in place-particularly the lack of access to broadband in lower-income and rural communities and the disparities in smartphone and compatible device ownership-that should be addressed when discussing advancement in telehealth. ACEP therefore supports efforts, such as the Federal Communication Commission's (FCC's) Connected Care Pilot Program, which cover the costs of broadband connectivity, network equipment, and information services necessary to provide telehealth and other remote care services to patients in rural and underserved communities, as well as other efforts to reduce and eliminate existing gaps in access for other vulnerable or in-need populations.