As you have seen yourself and heard from your emergency physician colleagues around the country, our hospital emergency departments (EDs) have reached or are past the breaking point due to a long-standing problem known as “boarding,” where patients are held in the ED following stabilization and care awaiting an inpatient bed or space in a tertiary facility where they can be safely transferred.

During the ACEP Leadership and Advocacy Conference in DC and through our 911 Action Alerts, we have been urging Congress to take action on the boarding crisis. 

One action is asking your House member to sign a bipartisan congressional “Dear Colleague” letter urging the Administration to swiftly convene an ED Boarding Task Force with broad stakeholder representation. 

The letter closes on May 24 so we need your immediate action.

The more legislators that sign onto the request to the Administration, the more likely it is that they will make it a priority!

Click here to take action. 

On Wednesday, Senators Bob Menendez (D-NJ) and John Boozman (R-AR) reintroduced the bipartisan “Prevent Blood Loss with Emergency Equipment Devices (BLEEDing) Act,” ACEP-supported legislation to authorize grant programs under the Department of Health and Human Services (HHS) and Administration for Strategic Preparedness and Response (ASPR) to expand access to training like Stop the Bleed programs and bleeding control kits in schools, malls, houses of worship, libraries, and other public spaces in communities across the country.

ACEP President Christopher S. Kang, MD, FACEP, was quoted in the legislators’ press release, stating: "In an emergency, a matter of seconds can be the difference between life and death. Just like knowing CPR, how to help a choking victim, or how to use an AED, with basic training and access to bleeding control kits, we can empower millions of potential lifesavers to be the help and stop the bleed, until help arrives.”

ACEP will continue advocating for this legislation, and in our recent responses to congressional requests for information (RFIs) on the reauthorization of the Pandemic and All-Hazards Preparedness Act, we urged Congress to include this legislation in that effort.

This week, the House Committee on Ways and Means held two hearings on health care price transparency and consolidation.

On Tuesday, the full committee held a hearing, entitled, “Health Care Price Transparency: A Patient’s Right to Know.” The hearing covered a variety of topics, including issues with enforcement of hospital price transparency provisions, non-profit vs. for-profit health care systems, competition and transparency challenges in rural areas, and concerns about overpayments and gaming of the system in Medicare Advantage plans, among many others.

And on Wednesday, the Ways and Means Subcommittee on Health held a hearing, entitled, “Why Health Care is Unaffordable: Anticompetitive and Consolidated Markets.” The hearing examined numerous topics, including concerns regarding insurers acquiring pharmacy benefit managers (PBMs), pharmacies, and medical practices; hospital system consolidation via purchases of smaller hospitals and physician practices; prohibitions on new physician-owned hospitals; and, issues regarding Medicare site-neutrality policies. 

Both Chairman Vern Buchanan (R-FL) and Ranking Member Lloyd Doggett (D-TX) noted the opportunity for bipartisan collaboration to increase competition and reduce anticompetitive practices across the health care sector, but did not indicate any timeline or specific policies the subcommittee might pursue.

On Wednesday, the Senate Health, Education, Labor, and Pensions (HELP) Committee, Subcommittee on Primary Health and Retirement Security held a hearing entitled “A Crisis in Mental Health and Substance Use Disorder Care: Closing Gaps in Access by Bringing Care and Prevention to Communities,” to address the pressing crisis of mental health access and substance use disorder care. The hearing highlighted persistent challenges, including gaps in access, overprescription of medications, and the impact of social media on mental health.

ACEP submitted a statement for the record, emphasizing the emergency department boarding crisis; growing rates of health care workplace violence; use of innovative alternative models to improve emergency psychiatric care and reduce psychiatric patient boarding; and the need for parity between behavioral and physical health care. The panel’s witnesses offered testimony in support of closing gaps in access to care, stressing the importance of reauthorizing and supporting programs introduced in recent legislation, while also advocating for the expansion of certified community behavioral health clinics (CCBHCs). ACEP will continue to monitor the Committee’s interest in addressing the mental health and substance-use disorder care crisis, and work with members to advance emergency medicine priorities in this space.

ACEP recently launched the 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. 

Molina Healthcare of Wisconsin rolled out a policy earlier this year that denied payment for critical care services when the patient was subsequently discharged from the hospital without being admitted. National and WI ACEP submitted a complaint to the WI insurance commissioner in March detailing our concerns. Our letter outlined the importance of critical care services and the numerous instances when the initial encounter does not result in a patient being admitted. On May 18th, the insurance commissioner’s office sided with ACEP and ordered Molina to stop denying critical care claims for payment under their policy. 

To share legislative activity happening in your state, please 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 & Crowding 
• Private Payer/Insurance 
• All Other Bills 

After five years at ACEP, four of which were spent writing this weekly breakfast blog (around 190 posts!), Jeffrey Davis has decided to pursue another opportunity. Beginning in June, he will start a new position as a Health Policy Director at McDermott+Consulting, a Washington, DC-based health policy and lobbying consulting firm.

Read his last Regs and Eggs blog post at ACEP as we celebrate our advocacy wins together and commiserate together on our defeats and ongoing struggles.