Click here to send a message to your Senators!

Emergency physicians could once again face drastic reductions to Medicare payments at the end of the year due to sequestration and Medicare’s “budget neutrality” requirements – a more than 10% cut that would jeopardize patient access to lifesaving emergency care. 

In the House, Reps. Ami Bera, MD (D-CA) and Larry Bucshon, MD (R-IN) have introduced H.R. 8800, a bipartisan bill that provides an additional 4.42% to the Medicare Physician Fee Schedule (PFS) conversion factor for 2023 and acknowledges the necessity of long-term physician payment reform. While the list of House cosponsors of this bill continues to grow, in large part due to your advocacy, we also need the Senate to act before the end of the year to prevent these harmful cuts. 

As Congress approaches the end of the year, legislators need to hear from you – as an emergency physician on the front lines – that these cuts will further destabilize the health care safety net and threaten patient access to care. If you haven’t already, please also urge your Representative to co-sponsor the "Supporting Medicare Providers Act of 2022" (H.R. 8800).

Last week, ACEP launched a campaign to sound the alarm on the national crisis around boarding in the emergency department and encourage the White House to convene a summit to address the systemic issues involved. Your stories shaped our letter to the White House and have helped us garner great media attention. If you're interested in submitting a story or potentially speaking with media, please click here. Any potentially identifying information included in a story will be redacted to ensure you remain protected. Visit our Boarding resource page to learn more about ACEP’s advocacy efforts. 

New research available from Stanford University demonstrates the importance of physician-led care teams. Researchers comparing emergency care delivered by independent nurse practitioners (NPs) to that of physicians in the Veterans Health Administration found that using NPs instead of physicians led to higher costs, lower quality of care, and worse outcomes. This is the first emergency medicine-specific research to compare these professions using real world experience and causal analysis. A summary and infographic are available on the latest ACEP Board Blog. 

On Thursday, Speaker of the House Nancy Pelosi (D-CA) announced that she will not seek a leadership position for the Democratic Caucus in the upcoming 118th Congress. The first woman to become Speaker in the history of the House, her announcement caps two decades leading the caucus through numerous high-profile legislative efforts.

In what amounts to a seismic shift in Democratic House leadership, Majority Leader Steny Hoyer (D-MD) and Majority Whip James Clyburn (D-SC) also announced that they would not run for their positions again in the next Congress, though while Hoyer will step out of leadership entirely, Clyburn is expected to seek a different position as Assistant Democratic Leader. These moves pave the way for Representatives Hakeem Jeffries (D-NY), Katherine Clark (D-MA), and Pete Aguilar (D-CA) who are expected to fill the top three positions for the Democratic leadership.

On the Republican side of the House, Minority Leader Kevin McCarthy (R-CA) was selected by the members of the GOP Conference to be the nominee for Speaker in the 118th Congress. McCarthy fought off a challenge from House Freedom Caucus member Andy Biggs (R-AZ), winning the nomination in a 188-31 vote. However, McCarthy will need 218 votes when the next Congress convenes in January, and is expected to spend the next several weeks fending off a revolt from the Freedom Caucus to secure the necessary support to lead a very slim majority.

On the other side of the Capitol, the Senate GOP also faced its own contentious elections, with Senator Rick Scott (R-FL) running against Minority Leader Mitch McConnell (R-KY) for Republican leader. McConnell soundly defeated Scott in a 37-10 vote, but the challenge highlights growing tensions within the party in the wake of their disappointing election results. Senate Democrats will hold their party elections after the Thanksgiving holiday, though none of the current leadership is expected to change or face any challenge.

With respect to the legislative outlook for the lame duck session of Congress, there are several must-pass bills and other high-priority items that legislators are likely to consider in the coming weeks. These include a government funding deal needed before December 16 (either an omnibus spending package or another short-term continuing resolution), consideration of the National Defense Authorization Act (NDAA) to fund the Department of Defense (DoD), flood insurance, Medicaid assistance for territories, mental health legislation, Medicare extenders, and ACEP’s top priority for the year end, staving off an impending 10.5% cut to Medicare physician payments. While still unclear what Congress will ultimately get done, the year-end package is expected to begin coalescing when legislators return after the Thanksgiving holiday. 

With majority control of the U.S. Senate and House of Representatives at stake, the 2022 midterm elections were a battle to the finish. We can declare success for emergency medicine’s involvement in the midterm elections and give a special thank you to everyone who generously supported NEMPAC. The donations of ACEP members provided NEMPAC with the resources to support the congressional campaigns of many friends and champions of emergency medicine who we helped return to Congress or who will become new members in January.

The NEMPAC Board of Trustees carefully vetted hundreds of candidates with the help of our VIP donors, ACEP chapter leaders, and staff. We are confident that our participation in these elections will make a difference in the 118th Congress when emergency medicine will look for help on critical issues like Medicare reimbursement cuts, boarding and violence in our emergency departments, and protecting the future of our specialty amidst scope and workforce challenges. 

ACEP members’ support of NEMPAC is essential as we help educate the 118th Congress about the realities we are facing on the front lines and work to build new and stronger relationships on Capitol Hill.

NEMPAC Highlights in the 2022 Elections

• NEMPAC donated nearly $1.6 million to federal candidates, party committees, SuperPACs, and Independent Expenditures on both sides of the aisle
• 172 candidates were supported in the general election – 21 in Senate races and 150 in House races
• 95% of NEMPAC-supported candidates in the Senate and 97% in the House have won their races (with 4 races still undecided)
• Donations to candidates split 55% Democrat/45% Republican
• NEMPAC supported 19 physician candidates
• 45% of NEMPAC’s contributions for the 2022 cycle went to diverse candidates (defined as women and non-white/Caucasian candidates) with the overall diversity of congress currently at 43%.
• Nearly 500 campaign checks were delivered by ACEP members and staff during the election cycle through fundraising events in DC, back home in the district, and through virtual events - many co-hosted by NEMPAC.

U.S. House of Representatives
NEMPAC supported 150 candidates for the House of Representatives in the general election. 143 won their elections, four candidates lost, and three are undecided at this writing. In addition, 18 candidates lost a primary race or decided to retire after NEMPAC donated to their campaigns.

U.S. Senate 
NEMPAC supported 21 candidates for the Senate in the general election. 19 candidates supported by NEMPAC won their elections, one candidate lost (Rep. Tim Ryan in OH) and one race supported by NEMPAC is undecided in Alaska. Two ACEP member/emergency physician candidates supported by NEMPAC lost in their respective Senate primaries: Dr. Kevin Baumlin in Pennsylvania and Dr. Niki Thran in Vermont.

Physician Candidates
NEMPAC supported 19 physician candidates in the general election, including emergency physicians Rep. Raul Ruiz, MD (D-CA), Rep. Mark Green, MD (R-TN), and Rich McCormick, MD (R-GA), who were successful in their races. All NEMPAC physician “champions” in Congress were re-elected including Rep. Raul Ruiz, MD (D-CA), Rep. Ami Bera, MD (D-CA), Rep. Larry Bucshon, MD (R-IN), Rep. Greg Murphy, MD (R-NC), Rep. Kim Schrier, MD (D-WA), and Rep. Brad Wenstrup, DPM (R-OH).

NEMPAC also supported two physician candidates running in open seats:  Dr. Kermit Jones in CA-03 and Dr. Yadira Caraveo in CO-08. Dr. Caraveo won with a margin of less than 1,000 votes, while Dr. Jones’ race has not been called as of this writing.

For a complete listing of physician candidates who ran for Congress in 2022 and their race outcomes, click here.

Contributions or gifts to NEMPAC are voluntary and are not tax deductible for federal income tax purposes. The amount given or refusal to donate will not benefit or disadvantage you. By law, we may only use your contribution to support federal candidates if your contribution is made using a personal credit card or personal check. We are required to provide your employer’s name, your occupation, and to obtain an original signature of the ACEP member if contributing by credit card. NEMPAC encourages personal contributions. All non-personal contributions to NEMPAC will be used to defray costs of educational programs for NEMPAC and other activities permissible under federal law.

On Tuesday, the U.S. Food and Drug Administration (FDA) issued a Federal Register notice, Safety and Effectiveness of Certain Naloxone Hydrochloride Drug Products for Nonprescription Use, that may help facilitate the development and approval of certain nonprescription naloxone drug products, including through the switch of certain naloxone drug products from prescription to nonprescription status. Naloxone is a medicine that can help reduce opioid overdose deaths.

The notice includes a preliminary assessment that certain naloxone drug products may be approvable as safe and effective for nonprescription use. This preliminary assessment is intended to facilitate development and approval of nonprescription naloxone products; however, it is not a final determination that certain naloxone drug products are safe and effective for nonprescription use, and it does not mandate an immediately effective switch to nonprescription/over-the-counter (OTC) availability for naloxone.

A few weeks ago, the Centers for Medicare & Medicaid Services (CMS) established final Conditions of Participation (COPs) and other payment and structural parameters for rural emergency hospitals (REHs) in the Calendar Year (CY) 2023 Outpatient Prospect Payment System (OPPS) final regulation.

CMS understands that rural facilities are struggling with financial and staffing issues and wants to limit their administrative burden as much as possible. However, what effect will such lenient policies have on the quality of care that REHs will provide?  And, even with this flexibility, will any small rural hospitals or critical access hospitals actually convert to this new facility type next year?

Read the Regs & Eggs blog for ACEP’s analysis of the final REH policies and whether REHs will in fact achieve their overall purpose — to improve access to care in rural areas.