This week, two ACEP-supported bipartisan bills to address violence in the emergency department and other health care settings were reintroduced in the 118th Congress: 

• The “Workplace Violence Prevention for Health Care and Social Service Workers Act,” (H.R. 2663/ S. 1176), introduced by Reps. Joe Courtney (D-CT), Don Bacon (R-NE), Bobby Scott (D-VA), Alma Adams (D-NC), Brian Fitzpatrick (R-PA), and Jeff Van Drew (R-NJ); and by Sen. Tammy Baldwin (D-WI) in the Senate. This bill takes critical steps to address ED violence by requiring the Occupational Safety and Health Administration (OSHA) to issue enforceable standards to ensure health care and social services workplaces implement violence prevention, tracking, and response systems. It previously passed the House of Representatives twice in strong bipartisan votes.
• The “Safety From Violence for Healthcare Employees (SAVE) Act,” (H.R. 2584) introduced by Reps. Larry Bucshon, MD (R-IN) and Madeline Dean (D-PA). The SAVE Act establishes federal legal penalties for individuals who knowingly and intentionally assault or intimidate health care workers and provides grants to help hospitals and medical facilities establish and improve workplace safety, security, and violence prevention efforts.

ACEP President Christopher S. Kang, MD, FACEP was quoted in the press releases for these bills (linked above) and thanked the bill sponsors for their support on this pervasive and growing issue. These bills, along with the larger issue of ED violence, will be among the legislative priorities that emergency physicians will be advocating for during ACEP’s upcoming Leadership & Advocacy Conference. 

On Wednesday, the House Energy and Commerce Committee Subcommittee on Health convened a hearing legislative hearing entitled, “Examining Existing Federal Programs to Build a Stronger Health Workforce and Improve Primary Care.” During the hearing, Committee members highlighted the increased need to provide access to health care, particularly in rural areas. ACEP submitted a statement for the record highlighting increased burnout among emergency physicians and longstanding difficulties for recruitment and retention, especially within rural communities; policy proposals to address rural emergency care access such as establishing Emergency Medicine Health Professional Shortage Areas (HPSAs), expanded eligibility for federal student loan repayment assistance programs, and other benefits; suggestions to improve the recently established Rural Emergency Hospital (REH) designation such as creating an add-on code or modifier that clinicians can append to claims for services delivered; and the adverse effects on quality with expanded scope of nonphysician providers. ACEP continues working with legislators to advocate for the needs of the emergency medicine workforce in light of both existing and emerging challenges facing emergency physicians. 

Oklahoma ACEP launched an advocacy alert this week to oppose Senate Bill 458 that would expand the scope of practice for APRNs to prescribe controlled medications without physician supervision after 6,240 practice hours as well as then permit them to supervise APRNs that had yet to obtain the minimum required practice hours. 

The legislation has already passed out of the Senate and is now pending in the House. 

Oklahoma ACEP members: urge your State Representative to oppose this bill now!

To share legislative activity happening in your state, contact Christopher Johnson. Check out the state legislation that is currently identified and being tracked by ACEP:

• Scope of Practice
• Violence Against Healthcare Workers
• ED Boarding and Crowding
• Private Payer/Insurance
• All Other Bills

Come together for ACEP's Leadership & Advocacy Conference (LAC), April 30 – May 2, 2023 in Washington, DC, to advocate in person for your specialty and your patients. Check out the latest speakers and agenda and register now!

During the conference, you’ll join EM colleagues from across the country to tackle issues such as the current boarding crisis and develop tools to advocate and build relationships with policymakers at all levels. Programming is approved for AMA PRA Category 1 Credit™. 

NEMPAC VIP Reception (by invitation only)
Sunday, April 30 from 6:00 - 8:00pm, Hay Adams Hotel – Top of the Hay 
The NEMPAC VIP Reception is an excellent chance to network with ACEP leaders and your colleagues who support a strong, unified advocacy effort on behalf of emergency medicine and patients.

NEMPAC donors at the Sterling level or above ($600 for attending physicians/$60 for residents/fellows/medical students annually) are invited and encouraged to attend. Donors who are currently eligible will receive an invitation via email.

Click here to contribute to NEMPAC and secure your invitation.

Questions about your donation status? Click here to email us.

Congressional Dine-Around Events Sponsored by NEMPAC
Join your ACEP Board members and colleagues! The NEMPAC Board has identified Congressional leaders deserving of special recognition and support for their work on national health policy impacting emergency medicine and patients. NEMPAC is hosting in-person dinners during LAC23 as a unique opportunity to discuss health care policy and the national political environment in small group settings. NEMPAC is donating to these legislators' campaigns and attendees are asked to donate personally as well. Food and drink are included with your contribution. 

An RSVP is required to attend the dine-arounds – click here to email us. 

Confirmed dine-arounds*:

• Rep. John Joyce, MD (R-PA-13), Sunday, April 30, Dinner, 7:30pm, Joe’s Seafood, Prime Steak & Stone Crab, 750 15th St NW
• Sen. Gary Peters (D-MI), Monday, May 1, Reception, 6:30-7:15pm, 224 7th St SE
• Rep. Larry Bucshon, MD (R-IN-08), Monday, May 1, Dinner, 6:30pm, The Capital Grille, 601 Pennsylvania Ave NW
• Sen. Ben Cardin (D-MD), Monday, May 1, Dinner, 6:00pm, Bistro Bis, 15 E St NW
• Sen. Michael Bennet (D-CO), Tuesday, May 2, Reception, 6:15-7:00pm, The Dubliner, 4 F St NW

*The dine-around schedule is subject to change and additions.

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 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.

ACEP recently launched the 911 Network Advocacy Leaders Program to support emergency physicians interested in taking their engagement and advocacy with federal legislators and staff to the next level. If you are interested in joining or already have a relationship with a federal legislator, complete this short form to receive more information.

During LAC23, there will be a special lunch session for our ACEP Advocacy Leaders on Monday, May 1 at noon. Brad Fitch, President and CEO of the Congressional Management Foundation, has created a special presentation to help you take your advocacy to the next level. A boxed lunch will be provided to the first 50 Advocacy Leaders who register for this session – contact us to reserve your lunch spot!

On Wednesday, ACEP responded to a Centers for Medicare and Medicaid Services (CMS) proposed rule that modifies how disproportionate share hospital (DSH) payments are calculated for hospitals in certain states participating in Medicaid Section 1115 demonstrations. If this proposed rule is finalized, DSH payments would be cut in six states: Florida, Kansas, Massachusetts, New Mexico, Tennessee, and Texas. CMS roughly estimates that overall payments to these hospitals will be reduced by $348.7 million if the proposal is finalized.

In our response, ACEP expresses concerns about the impact that these cuts could have on the financial viability of hospitals in these six states, especially those in rural areas that depend on DSH payments.  Hospital closures are already a significant issue, and budget cuts could cause long-term staffing and recruitment issues, limiting patient access and choice in the surrounding area.

Millions of people were able to keep their Medicaid coverage, regardless of their eligibility, during the COVID-19 public health emergency. States that maintained their Medicaid rolls received additional federal funds. However, those additional funds are going away, and beginning April 1, 2023, states could start the Medicaid redetermination and renewal process. Specifically, they must contact every Medicaid enrollee in their state to check their eligibility and assist with re-enrollment of transfers to ACA Marketplace Plans.

Read the Regs and Eggs blog post for an overview of how these redeterminations and renewals will work, what different states are doing, and what this all means for you as emergency physicians and your patients.