Our monthly Leadership Report is the best way to stay apprised of how ACEP leaders are working on your behalf to advance emergency medicine. We know the challenges our members face, and we are continually taking steps to protect your interests and make it easier for you to provide the highest quality care for your patients. Keep reading for the latest updates from the national office.
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Board of Directors Considers Influenza, Firearm Safety Research, Protected Time and More During April Meeting
ACEP’s Board of Directors convened April 10-11 and discussed several issues related to clinical topics and practice trends. Among their decisions, they voted in favor of:
Surveying the Council for a representative viewpoint on firearm-associated research, safety and policy
A policy statement about Salary and Benefits Considerations for EMS Professionals, which will provide justification for fair compensation regarding the dangers and risk as well as the out-of-hospital environment in which EMS providers operate.
A policy statement about Violence Prevention & Intervention in EMS System, which will provide the needed guidance regarding implementing steps to attain and maintain an EMS culture of patient and personnel safety
Hosting ACEP24 in Las Vegas
Creating a national Wellness award to celebrate institutions or organizations that demonstrate best practices when it comes to physician wellness, with the inaugural award presented during ACEP20
Partnering with the Center for Improvement in Healthcare Quality to develop an accreditation process for freestanding emergency centers
Approving an Influenza ED Best Practices information paper
Submitting a white paper to Annalsabout the potential impact of the Accreditation Council for Graduate Medical Education’s proposed policy that would restrict protected time for core faculty
Candidates Announced for Board, Council
The following candidates are running for ACEP leadership positions in 2019. Elections will take place during ACEP Scientific Assembly in Denver. More information on the candidates will be forthcoming.
Jon Mark Hirshon, MD, FACEP (MD)
Mark Rosenberg, DO, FACEP (NJ)
Gary Katz, MD, FACEP (OH) – unopposed
Kelly Gray-Eurom, MD, FACEP (FL)
Andrea Green, MD, FACEP (TX)
Howard Mell, MD, FACEP (IL)
Board of Directors (four open positions)
Michael Baker, MD, FACEP (MI)
Jeffrey Goodloe, MD, FACEP (OK)
Rachelle Greenman, MD, FACEP (NJ)
Gabor Kellen, MD, FACEP (AACEM)
Pamela Ross, MD, FACEP (VA)
Gillian Schmitz, MD, FACEP (incumbent – GS)
Ryan Stanton, MD, FACEP (KY)
Thomas Sugarman, MD, FACEP (CA)
EM Physician Named Chief Executive Officer of AOA
ACEP Board member Kevin Klauer, DO, EJD, FACEP, has been appointed chief executive officer of the American Osteopathic Association, the professional membership organization for more than 145,000 osteopathic physicians and medical students. As CEO, he will be responsible for strategy, operating results, organizational growth and advocacy.
“We are thrilled for Dr. Klauer to join the AOA as our next CEO,” said AOA President William S. Mayo, DO. “The DO profession is undergoing significant growth, with approximately one in four medical students attending a college of osteopathic medicine. This is a pivotal moment for the osteopathic profession and health care overall, and we are confident in Dr. Klauer’s experience to lead us through a dynamic and evolving landscape.”
Dr. Klauer, an ACEP member since 1992 and current Medical Editor-in-Chief of ACEP Now, will finish his current term on the ACEP Board of Directors in October 2019 and will help transition a new emergency physician into the role of ACEP Now Medical Editor-in-Chief.
ACEP Supports Workplace Violence Prevention Act
Violence in the ED is a serious and growing concern. ACEP’s 2018 survey reported that nearly half of EM physicians polled had been physically assaulted, with more than 60 percent occurring in the past year. ACEP recently sent a letter of support for H.R. 1309: The Workplace Violence Prevention for Health Care and Social Service Workers Act, asking Congress to consider how EDs are staffed to ensure the important provisions of this legislation are implemented appropriately. ACEP's letter requested additional clarity of the legislation's wording to ensure any new federal requirements do not create any unintentional burdens for entities that do not control the health care workplace. Read more at www.acep.org/EDsafety.
ACEP Submits Statement on Surprise Billing, Bundled Payments
On April 2, ACEP submitted a statement for the record to the House Committee on Education’s Subcommittee on Health, Employment, Labor, and Pensions that urged legislators to take into account the unique nature of emergency medicine while examining the surprise billing issue. The letter explains how EMTALA has disincentivized health plans from entering into fair and reasonable contracts to provide services at appropriate in-network rates.
This letter also explains ACEP’s stance on recent proposals related to bundled payments: “We also note our strong concerns with proposals that would either provide a single bundled payment from a hospital for emergency services or would set a benchmark payment at a certain level of Medicare rates. A bundled payment would not actually address the underlying cost issues, but instead merely shift the venue for negotiation under the assumption that hospitals would somehow be able to better negotiate with physicians than insurers.”
ACEP, NAEMT Partner to Celebrate EMS Week
The 45th National EMS Week is May 19-25, bringing together local communities and medical personnel to publicize safety and honor the dedication of EMTs. In 1974, President Gerald Ford authorized EMS Week to celebrate EMS practitioners and the important work they do in our nation's communities. Presented by ACEP and the National Association of EMTs (NAEMT), our EMS 2019 theme is “BEYOND the CALL.”
Want to catch up fast? Here's the latest edition of ACEP's Capital Minute:
ACEP Applauds House Passage of Bill on Universal Background Checks for Firearm Transfer or Sale
ACEP sent a letter of support for H.R. 8, the “Bipartisan Background Checks Act of 2019,” which, introduced by Reps. Mike Thompson (D-CA) and Peter King (R-NY), would extend the existing system of background checks for firearms transactions to all sales, with certain exceptions for law enforcement, gifts to family members, and transfers for hunting, target shooting, and self-defense purposes. ACEP’s own policy supports universal background checks for firearms, and ACEP has supported similar legislation in the past. The House voted on and passed H.R. 8, though it is unlikely to be taken up in the Senate. Read the press release at newsroom.acep.org.
Emergency Physician Named First Chief Medical Officer of the Office of National Drug Control Policy
The White House Office of National Drug Control Policy (ONDCP) announced that Roneet Lev, MD, FACEP, an emergency physician from San Diego, California and member of the American College of Emergency Physicians (ACEP), will serve as ONDCP’s first ever Chief Medical Officer.
“It is an honor and privilege to serve the administration and the American people,” said Dr. Lev. “I will integrate my 25 years of clinical experience to work on the prevention, treatment, and enforcement aspects of drug addiction. ONDCP Director James Carroll make it very clear that the purpose of our every day job is to save lives – just like what emergency physicians do every shift.”
“We are thrilled that Dr. Lev not only proudly represents emergency physicians in this prestigious role, but also the millions of emergency patients who rely on us every day for essential care,” said Vidor Friedman, MD, FACEP, president of ACEP. “Once again, the importance of emergency medicine is being recognized at the highest levels of government.”
Read the press release.
Recent Advocacy Efforts Focus on Out of Network Billing Issues
ACEP President Vidor Friedman, MD, FACEP, has conducted many meetings on Capitol Hill as part of continued outreach to address out-of-network billing issues and other issues important to emergency medicine. During a busy two-day sprint, Dr. Friedman met with with Senators Lamar Alexander (R-TN), Marsha Blackburn (R-TN), Sen. Patty Murray (D-WA), ranking member of the HELP Committee, as well as HELP Committee Republican staff, staff for Senator Bill Cassidy (R-LA), staff for House Minority Leader Kevin McCarthy (R-CA), Rep. Darren Soto (D-FL), and Rep. Mike Burgess, MD (R-TX), ranking member of the House Committee on Energy and Commerce Health Subcommittee. The following day, Dr. Friedman met with Sen. Maggie Hassan (D-NH), a member of the Senate Bipartisan Price Transparency Workgroup and author of her own surprise billing legislation, and attended a fundraiser with Sen. Johnny Isakson (R-GA).
ACEP’s DC staff continues to supplement Dr. Friedman’s ongoing advocacy efforts with dozens of meetings with key legislators and other stakeholders. ACEP responded to a data request sent to a number of physician associations and groups, hospitals, and insurers by the Senate bipartisan transparency workgroup led by Senator Cassidy that is developing federal legislation to address so-called “surprise bills.”
Sepsis Discussions Continue
ACEP recently met with the Society for Critical Care Medicine to discuss the issues around the Sep-3 definition of sepsis and the difficulties some EM physicians are having with reimbursement and meeting quality measures. Many of the components of the Sep-3 definition require laboratory values or time (response to fluids). Studies have shown that the Sep-3 definition is not accurate in the ED, and CMS does not use Sep-3. ACEP has sent letters to the insurance companies that have used Sep-3 in denials. SCCM provided some language for that letter but declined to sign it with ACEP.
ACEP and SCCM also discussed the 1-hour bundle. ACEP is working on a new guideline for early emergency care for septic patients. ACEP and SCCM agreed to look at joint research projects that would concentrate on early care of sepsis.
EM Physician Advocates During Surprise Billing Panel
ACEP board member Tony Cirillo, MD, FACEP, gave compelling opening remarks about the role of EPs during a surprise billing panel hosted by the Brookings Institute. Watch his remarks, which begin at 2:31:18 in the video.
Emergency Physician Advocates for SUD Funding on Capitol Hill
Eric Ketcham, MD, FACEP, participated in a congressional briefing sponsored by the Coalition to Stop Opioid Overdose (CSOO) and the Mental Health Liaison Group (MHLG), to share his perspective as an emergency physician who treats individuals with substance use disorders (SUDs) and to encourage Congress to continue its important efforts to address the nation’s opioid epidemic.
Dr. Ketcham’s remarks focused on the unique role of emergency medicine and how emergency departments can better coordinate with resources in the community to ensure patients receive appropriate short- and long-term care. He also reinforced the need for Congress to appropriate necessary funding for the Alternatives to Opioids (ALTO) and Preventing Overdoses While in Emergency Rooms (POWER) Acts that were passed into law by Congress last year as part of H.R. 6, the SUPPORT Act. These two ACEP-developed bills were authorized by Congress last year and now require funding to ensure these critical resources can help expand the reach of emergency medicine to better serve patients with SUDs.
Scoot Safe! Public Health and Safety Campaign Launches
Scooter-related ED visits are on the rise, so ACEP launched a public health and safety campaign to urge millions of electronic scooter riders to scoot safely. The campaign features a public service announcement and downloadable poster that offers commonsense tips for scooter riders.
ACEP and ASA Discuss Procedural Sedation, Opioids, OON Billing
ACEP leadership met with the American Society of Anesthesiologists Feb. 28 to discuss ACEP’s recent guideline on procedural sedation, the opioid epidemic, and out-of-network billing. Our groups were mutually interested in the topic of physician wellness and agreed physicians should be able to get help for mental illness without jeopardizing their license or hospital privileges. Other issues discussed included firearm violence, drug shortages and independent practice by Pas and NPs.
Committee Selection Process Opens
ACEP President-Elect, William P. Jaquis, MD, FACEP, has opened the selection process for appointing members to serve on national ACEP committees during fiscal year 2019-20. Committee interest forms are due May 17. Find more information about committee roles and selection.
Want to catch up fast? Here's the latest edition of ACEP's Capital Minute:
ACEP Board Considers Firearm Safety, Leadership Diversity and More During January Meeting
In late January, the ACEP Board of Directors met and considered several issues related to practice trends and clinical topics. Among their decisions, they voted in favor of:
ACEP Presents Framework to Protect Emergency Patients from Out-of-Network Billing
On Jan. 28, ACEP released a framework of proposed solutions to protect emergency patients from surprise billing. The proposed solutions include:
Seeking Editor-in-Chief for New EM Journal
ACEP is launching a new open access journal in 2020 and is seeking applicants for editor-in-chief. The editor will participate in the full-scale launch work of the journal, including creation of the editorial board and strategic editorial plans. Applications are due March 25.
Response to ONC Draft Strategy on Reducing Administrative Burden Regarding the Use of Health IT
ACEP responded to the Office of the National Coordinator for Health Information Technology’s (ONC’s) draft strategy on ways to reduce burden for providers using health information technology (IT) and electronic health records (EHRs). In general, ACEP supports the main recommendations included in the draft strategy and appreciates the efforts the Administration has already taken to reduce provider burden and to improve the usability and exchange of information. In our comment letter, we described ways CMS can further reduce provider reporting burden under the Merit-based Incentive Payment System (MIPS). Lastly, we expressed our disappointment that the draft strategy does not address the effectiveness of qualified clinical data registries (QCDRs) or what the Administration can do to encourage these as a way of reporting quality measures.
Collecting Comments on Clinical Policy Draft for Acute Headache
The draft “Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting to the ED With Acute Headache,” is in the review stage of development and is open for comments until April 1.
ACEP Represented at Surprise Billing Event
Board member Tony Cirillo, MD, FACEP, represented ACEP on a panel for a Brookings Institution event, “Emerging Policy Solutions to Surprise Medical Bills,” along with other panelists from organizations representing lawmakers, hospitals, insurers, and consumers. Dr. Cirillo emphasized principles from ACEP’s recently released framework to protect emergency patients when care is out-of-network.
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April 2019 Highlights
Our clinical affairs team helped persuade United Healthcare to change a Managed Medicaid policy that denied or down-coded emergency claims based on final diagnosis in 23 states - a violation of the Prudent Layperson Standard ACEP fought hard to establish. By writing letters to UHC and helping ACEP members turn up the heat, the policy has been reversed in all but two states, potentially saving ACEP members millions in lost reimbursement.
Our educational products team worked with Amazon to make the second edition of the ECG book on Amazon’s print-on-demand in six new marketplaces: UK, France, Italy, Germany, Spain, and Japan. This improvement greatly reduces shipping fees for our international customers.
Our legislative team in ACEP's DC office drafted legislation to create a grant program that will facilitate moving psychiatric/mental health patients out of the ED and into more appropriate treatment settings. This language is currently being reviewed by House and Senate lawmakers for possible sponsorship.
Our member communications team compiled salary information from ACEP and external sources to make a one-stop-shop online resource for members trying to negotiative appropriate compensation.
Our Annals of Emergency Medicine team worked with the husband of an Annals author to surprise his wife by framing a copy of her article.