Regulatory Affairs, Above What We Do

What We Do

As part of our overall federal advocacy strategy, ACEP’s Regulatory Affairs team plays an active role in monitoring and influencing federal regulations and other policies developed by federal agencies. ACEP also advocates on behalf of our members to reduce burdensome requirements that impact their ability to treat patients, ensure fair reimbursement, and eliminate unfair insurer billing practices.

With a new presidential administration, new dynamics in government agencies are emerging. ACEP is cutting through the noise to make sure that your concerns are heard by key decisionmakers at all levels, and that we explore new opportunities related to insurance reform, boarding, workplace protections, and new payment models in Medicare. We will seize every chance to champion your priorities as determined by the ACEP Council, the deliberative body that empowers emergency physicians to vote to determine ACEP policies.

In addition, ACEP works with other influential nongovernmental organizations to advocate for important issues affecting emergency physicians.

Medicare Reimbursement

Emergency physicians provide the vast majority of acute care for Medicare and Medicaid patients in the U.S. Medicare rates are often used to set Medicaid and private payor payment rates, yet they do not cover the costs of providing care and have not kept up with the pace of inflation over the last few decades.

Merit-based Incentive Payment System (MIPS)

The Medicare Physician Fee Schedule (PFS) regulation makes updates to the Quality Payment Program (QPP), the major quality reporting program for physicians under Medicare.

Weekly Updates

On September 15, CMS released data that highlights trends in the use of telehealth services between January 1, 2020 and March 31, 2022. The data allows for analysis of telehealth utilization by quarter, state, and various demographic characteristics.
On September 14, CMS published “Request for Information: Advanced Explanation of Benefits and Good Faith Estimate for Covered Individuals.” This document is a request for information (RFI) to inform DOL, HHS, the Treasury, and OPM’s rulemaking for advanced explanation of benefits (AEOB) and good faith estimate (GFE) requirements of the No Surprises Act.
On September 12, CMS announced that people with Medicare, Medicaid, Children’s Health Insurance Program (CHIP) coverage, private insurance coverage, or no health coverage can get COVID-19 vaccines, including the updated Moderna and Pfizer-BioNTech COVID-19 vaccines, at no cost, for as long as the federal government continues purchasing and distributing these COVID-19 vaccines.
On September 6, CMS released a request for information on called “Make Your Voice Heard: Promoting Efficiency and Equity Within CMS Programs.” CMS is seeking public input on accessing healthcare and related challenges, understanding provider experiences, advancing health equity, and assessing the impact of waivers and flexibilities provided in response to the COVID-19 Public Health Emergency.

Regulatory Affairs, Above What We Do

What We Do

Medicare Reimbursement

Merit-based Incentive Payment System (MIPS)

Weekly Updates

Questions? Contact ACEP's Department of Regulatory Affairs