This week, the House Republican Steering Committee officially set their new roster for committee leadership and selected new committee members. With their new majority comes a reversal of the committee ratios between the parties, giving many Republican members an opportunity to be seated on some of the more coveted committees, and stripping some of the less senior Democrats from their prized roles.

Of note is new Ways and Means Committee Chairman Jason Smith (R-MO), who won the top spot on this powerful committee with jurisdiction over taxes and the Medicare program. Rep. Richie Neal (D-MA) remains the top Democrat on this committee as the Ranking Member. New Republican members on the committee are Mike Carey (R-OH), Randy Feenstra (R-IA), Michelle Fischbach (R-MN), Brian Fitzpatrick (R-PA), Nicole Malliotakis (R-NY), Blake Moore (R-UT), Michelle Steel (R-CA), Greg Steube (R-FL), Claudia Tenney (R-NY), and Beth Van Duyne (R-TX).

On the Energy and Commerce Committee, leadership stayed the same but the roles have reversed, with Cathy McMorris Rodgers (R-WA) taking over as the first chairwoman of the committee, and Frank Pallone (D-NJ) relinquishing the gavel and serving as Ranking Member. The new members of the committee are Randy Weber (R-TX), Rick Allen (R-GA), Troy Balderson (R-OH), Russ Fulcher (R-ID), August Pfluger (R-TX), Diana Harshbarger (R-TN), Mariannette Miller-Meeks (R-IA), Kat Cammack (R-FL), and Jay Obernolte (R-CA).

On Wednesday, the House of Representatives took up two items related to abortion, one resolution and one bill, which passed on mostly party lines.

H. Con. Res. 3, a resolution expressing the sense of Congress “condemning recent attacks on pro-life facilities, groups, and churches,” passed in a 222-209 vote, with three Democrats crossing party lines for the vote. H.R. 26, the Born-Alive Abortion Survivors Protection Act, would require health care practitioners to provide care for an infant born alive following an abortion or attempted abortion. The legislation would establish criminal penalties (monetary penalties, up to five years imprisonment, or both) for practitioners who fail to provide the required care. H.R. 26 passed in a 220-210 vote, with Rep. Henry Cuellar (D-TX) as the lone Democrat supporting the bill. Republicans argued that the bill would ensure infants receive the care they deserve, while Democrats argued that health care providers are already required by law to provide appropriate medical care after an abortion under a law passed more than two decades ago.

Neither the bill nor the resolution is expected to be considered by the Senate. ACEP continues to monitor any legislative efforts that would interfere with or otherwise affect a clinician’s ability to practice evidence-based medicine, including policies to criminalize the provision of medical care.

ACEP has launched a new 911 Network Advocacy Leaders program for emergency physicians interested in taking their engagement and advocacy with federal legislators and staff to the next level. Check out our webinar recording to hear more about the goals and structure of the program, preview ACEP’s advocacy priorities for the 118th Congress, and learn about early opportunities to engage with your legislators back home, along with a sneak peek at additional advocacy opportunities planned for the year.

Fill out this form to sign up for the program and receive information on next steps!

The X-waiver requirement has officially been eliminated! On Thursday, the Drug Enforcement Administration (DEA) issued guidance on the removal of the X-waiver— an ACEP priority that was included in the Consolidated Appropriations Act, 2023. As stated in the guidance, an X-Waiver is no longer required to treat patients with buprenorphine for opioid use disorder. Going forward, all prescriptions for buprenorphine will only require a standard DEA registration number. There are no longer any limits or patient caps on the number of patients a prescriber may treat for opioid use disorder with buprenorphine. Existing state laws or regulations still apply. The Substance Abuse and Mental Health Services Administration (SAMHSA) will no longer be accepting new waiver applications.

Separately, the Consolidated Appropriations Act, 2023  introduced new training requirements for all prescribers. These requirements will not go into effect until June 21, 2023. The DEA and SAMHSA are actively working to provide further guidance and DEA will follow up with additional information on these requirements shortly. 

Click here for more information.

Last week, the Federal Trade Commission (FTC) proposed to ban non-compete clauses in all employment contracts, which could impact many emergency physicians if such a policy is eventually finalized. The ban would also apply retroactively and affect current contracts that include non-compete clauses.

Is this a game-changer? Read the Regs and Eggs blog post for an analysis of the proposed reg and ACEP’s plan for responding to this important potential policy change.

The Secretary of the U.S. Department of Health and Human Services (HHS), Xavier Becerra, has extended the COVID-19 public health emergency (PHE) for another 90 days. It was set to end on January 11, 2023, and is now due to expire on April 11, 2023. This is the 12th time the HHS Secretary has extended the PHE. 

HHS has stated that it will provide 60-days' notice prior to any termination of the PHE.

On Monday, the Centers for Medicare & Medicaid Services (CMS) announced that it has awarded the first 200 of 1,000 Medicare-funded physician residency slots provided in the Consolidated Appropriations Act, 2021. Approximately three-quarters of the new positions will be for primary care and mental health specialties. The application period for the second round of 200 residency positions will open in January 2023 and close on March 31, 2023.

ACEP previously supported CMS’ overall approach to allocating these additional slots.

This week, New York Governor Kathy Hochul unveiled a plan during her State of the State address to invest $1 billion to expand access to mental health services including opening 1,000 new hospital beds for psychiatric patients. In addition to these funds, the governor’s plan also includes a proposal designed to encourage hospitals to reopen psychiatric beds they are licensed for by authorizing the NY Office of Mental Health to fine hospitals that do not open those existing psychiatric beds $2,000 per day per bed. 

Investment in additional psychiatric beds and mental health services is one of numerous policy options to help address the current emergency department boarding and crowding crisis. It is expected that Governor Hochul’s mental health legislation will be included in her budget proposal to be released in February.

ACEP is reviewing and tracking mental health related state legislation, including proposals to increase access to care and services such as 988. Click here to view the current mental health bills being tracked. 

Physician Wellness:

• Nebraska, LB 286, provides for confidentiality of a physician wellness program.

Health Care Violence Prevention:

• Oregon, SB 563, adds assault of healthcare worker as Class C felony and provides exemptions from prosecution for certain people including those suffering from mental health issues.
• West Virginia, HB 2146, defines different "types of violence" and requires employers to develop comprehensive workplace violence prevention plan.

Scope of Practice: 

• Oregon, HB 2583, to change the titles for physician assistants to “physician associates.”
• Virginia, SB 1105, would end joint licensure of nurse practitioners by the Board of Medicine and Board of Nursing giving the Board of Nursing full regulatory authority of NPs. Virginia is the only state with a joint-board licensure of NPs.

Insurance Bad Practice:

• Texas, HB 1236 adds language to further strengthen the state’s prudent layperson law.

Click here to view the full list of bills currently identified and being tracked by ACEP. For more information or to share legislative activity happening in your state, contact Christopher Johnson.