ACEP’s High Priorities for the Implementation of the Patient Protection and Affordable Care Act of 2010

August 18, 2010

ACEP's High Priority Provisions Chart

Since President Barack Obama signed the “The Patient Protection and Affordable Care Act of 2010” into law, ACEP has scrutinized this massive piece of health care reform legislation to determine how it will affect emergency physicians and emergency patients.

I directed the Federal Government Affairs Committee to take the lead in this review, and under their direction, ACEP analyzed every word of the law’s more than 2,000 pages and proposed new priorities and tactics to the Board of Directors, which they approved in June.

ACEP will turn up the volume in the coming year to clarify the priorities of emergency medicine to policymakers. On behalf of ACEP, I will be sending a letter to U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius outlining the health care reform priorities of emergency medicine. HHS has significant new authority under the law, and it’s critical that the specialty of emergency medicine be in close communication with these policymakers.

The details of this new law are critical to its final impact on your practice, and these details will be finalized through a complex federal regulatory process that will go on for years. ACEP is dedicated to protecting and promoting the interests of emergency patients and emergency physicians, making the implementation process a top priority. ACEP did not take a position on the law, but did support the inclusion of several provisions relevant to emergency medicine; however, emergency physicians must remain vigilant through the implementation process to preserve the intended original benefits.

As the provisions of health care legislation are implemented, one of ACEP’s biggest concerns continues to be that emergency visits will increase despite health care reform, and that policymakers still need to focus on increasing efficiencies in emergency departments, enacting medical liability reform and providing additional resources to care for the millions of patients seeking emergency care each year.

In addition, ACEP is sounding the alarm on behalf of our patients regarding the growing disparity between the number of emergency department visits each year and the number of emergency departments. With the number of emergency department visits increasing rapidly and the number of emergency departments decreasing, there will be growing pressures on the existing resources to provide care. As you know,overcrowded emergency departments threaten patient safety and access to emergency care for everyone – insured and uninsured alike.

ACEP’s priorities outlined in the letter to Secretary Sebelius include:

  • Extend the “prudent layperson standard” to grandfathered health plans to eliminate the need for prior authorization.
  • Improve emergency department efficiencies.
  • Improve the physicians’ quality reporting system.
  • Recognize the important role emergency physicians play in providing the full continuum of care to Medicare beneficiaries.
  • Raise concerns about new Medicare payment mechanisms, such as bundled payments.
  • Distribute additional residency positions to emergency medicine residency programs.
  • Highlight the education and training needs of emergency medicine as the National Health Care Workforce Commission proceeds.
  • Represent the emergency medicine perspective in identifying research priorities and establishing and implementing the research project agenda.
  • Extend medical liability coverage and review the unique requirements of physicians who provide EMTALA-related services.
  • Consider how the Federal Tort Claims Act may be applied to ensure the availability of the emergency and on-call physicians.

ACEP will continue to lobby Congress to apply a permanent solution to fix the fundamentally flawed Medicare physician reimbursement formula. Even more Medicare patients will seek care in emergency departments if they are unable to get appointments with other physicians.

ACEP is also urging Congress to enact medical liability reform. Defensive medicine is one of the biggest drivers of health care costs. America’s medical liability system is broken and without true medical liability reform, costs will continue to increase, and access to lifesaving care will suffer.

We look forward to your continued support as ACEP moves forward to make sure health care reform serves our patients’ best interests.


Angela F. Gardner, MD, FACEP
President, American College of Emergency Physicians

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