This week, ACEP shared a letter with the recently-convened 118th Congress, detailing several of the College’s key legislative priorities.

Among the priorities included in the letter are:

• Efforts to address emergency department (ED) boarding and crowding, including a request for Congress to hold hearings and roundtables with stakeholders to identify policy solutions;
• Workplace violence prevention needs to reduce the threat of violence against emergency physicians, nurses, and other health care workers;
• Improving access to mental health care, including acute psychiatric needs as well as longer-term care options, through efforts such as the “Improving Mental Health Access from the Emergency Department Act” introduced in the previous Congress, as well as continued work to improve physician and provider mental health and address burnout;
• Policies needs for the upcoming reauthorization of the Pandemic and All-Hazards Preparedness Act (PAHPA) to improve preparedness for future outbreaks, natural disasters, and mass casualty events; and,
• Needed reforms and improvements to the Medicare physician payment system to ensure stability and security for physicians and beneficiaries alike.

ACEP has a broad legislative agenda that includes many other policy goals which we will continue advocating for throughout the 118th Congress to advance the cause of emergency medicine.

How You Can Help:

To reinforce ACEP’s letter to congressional offices, we urge you to send a brief welcome message to your U.S. Senators and Representative to establish your interest in advocating and becoming a resource on health care issues on behalf of emergency medicine and the patients you treat – their constituents. The message also outlines a few issues of importance to the specialty in this Congress as noted above. 

Contact your legislators today!

On Wednesday, the House Committee on Energy and Commerce Subcommittee on Oversight and Investigations and Health Subcommittee held a hearing entitled, “The Federal Response To COVID-19.” Witnesses highlighted the need for emergency preparedness and response, and the continued strengthening of the FDA’s authority in building a resilient supply chain for critical medical products, foods, and medical countermeasures.

As Congress works to learn from the COVID-19 response, ACEP will continue to inform Congress on where our health care system needs improvement, including through the reauthorization of the Pandemic and All-Hazards Preparedness Act which is set to expire this year.

Come together for ACEP's Leadership & Advocacy Conference (LAC), April 30 – May 2, 2023 in Washington, DC, to celebrate emergency medicine’s accomplishments and advocate in person for your specialty and your patients. Register now and use discount code 911network for $100 off registration until March 31. 

During the conference, you’ll join with EM colleagues from across the country to tackle problems facing EM such as the current boarding crisis and develop tools to advocate and build relationships with policymakers at all levels. Experienced participants will build upon their already-valuable connections, while first-time attendees will be trained on effective ways to educate your Members of Congress and staff.

This year LAC will bring a fresh new focus on how you can advocate for yourself - even within the workplace - to improve your livelihood. Programming is approved for AMA PRA Category 1 Credit™ and will include:

• Getting policymakers’ attention on the boarding crisis
• Myth-busting the rules that govern your workplace, and advocating for change  
• How reversal of Roe vs Wade impacts you as an emergency physician
• Tools to advocate against erosion of physician-led care
• Leveraging your hospital’s committees and other opportunities for leadership growth and influencing change
• What really determines your paycheck?
• How ACEP advocacy turns into laws 

Interested in taking your engagement and advocacy with federal legislators and staff to the next level? Fill out this form to receive information about opportunities to engage with your legislators! Check out our webinar recording to hear more about ACEP's Advocacy Leaders program, advocacy priorities for the 118th Congress, and opportunities to engage with your legislators. 

Read the Regs and Eggs blog for an overview from Leslie Moore, ACEP’s General Counsel, of the major No Surprises Act Court decision, as well as highlights of the other legal actions that ACEP has taken to make sure your profession and livelihood as emergency physicians are protected.

On Wednesday, ACEP submitted a formal request to the Centers for Medicare and Medicaid Services (CMS) to have the lower-level emergency department evaluation and management (E/M) codes (levels 1-3) and the observation codes be permanently added to the Medicare Telehealth Services List. ACEP and 45 other organizations previously sent a letter to CMS asking the agency to extend the availability of codes that have been temporarily added to the Medicare Telehealth Services List until the end of calendar year (CY) 2024 in order to align with the new telehealth timeframe that Congress established in the 2022 omnibus bill. While we made this request for CMS to extend the codes through CY 2024, we also asked CMS to add the codes permanently to the Medicare Telehealth Services List.

On Monday, ACEP and EMRA responded to the Department of Education’s "Improving Income-Driven Repayment for the William D. Ford Federal Direct Loan Program" Notice of Proposed Rulemaking (NPRM). The NPRM seeks to help ensure that student loan borrowers have greater access to affordable repayment terms based upon their income, resulting in lower monthly payments and lower amounts repaid over the life of a loan. Our comments are supportive of the intent of the proposals. However, we request that the Department set the discretionary income threshold for determining monthly payments at 5 percent for both undergraduate and graduate loans; and set a maximum of a 20-year or lower repayment schedule until debt forgiveness for both undergraduate and graduate borrowers for all IDR plans in the Department’s portfolio.

A hearing on a Montana bill, HB 313, that would completely remove physician supervision of physician assistants (PA) was held in the House Business and Labor Committee on February 3rd. 

Nathan Allen, MD, FACEP, HEC-C and Secretary/Treasurer of the Montana Chapter American College of Emergency Physicians joined with the Montana Medical Association and other physicians testifying before the committee in opposition to the bill. Dr. Allen emphasized in his testimony that physician assistant education programs are not designed to prepare PAs for independent practice and that the legislation as introduced does not require PA education and training to adapt to an independent practice. Dr. Allen also noted that it is the physician’s duty to ensure patient safety and that the bill lacks any safeguards for patient safety and quality care. Read Dr. Allen’s testimony.

The committee did not vote on the bill after the bill’s sponsor, State Rep. Jodee Etchart, a practicing physician assistant, indicated that she would be introducing an amendment. A representative of Governor Greg Gianforte’s office testified in support of the bill.

A South Dakota physician assistant bill, SB 175, advanced out of the Senate Health and Human Services Committee on Wednesday.

South Dakota ACEP sent a letter to State Senators opposing this legislation that would remove physician supervision of PAs. The bill would establish a requirement that a PA with less than two thousand eighty practice hours sign a collaboration agreement with either a physician or PA who has completed four thousand practice hours. After surpassing the minimum practice hours, a PA would no longer need a collaborative agreement to practice in primary care or in the emergency department of a rural health care facility. 

The Senate is expected to vote on the bill as early as Monday, February 13th. 

Check out the state legislation currently identified and being tracked by ACEP. For more information or to share legislative activity happening in your state, contact Christopher Johnson.