Posts Tagged legislation

House Bill Includes Positives for EM

AngelaGarner1I orginally posted this entry on my personal blog, Gardner’s Gate. 

Last night the U.S. House of Representatives passed a health reform bill, H.R. 3962. Emergency physicians are divided in their thoughts about the consequences of this legislation, as is the house of medicine and the country in general. However, there are many aspects of the bill that are positive for emergency patients and for emergency physicians.

Some of these include:

  • Inclusion of emergency services as part of an essential health benefits package
  • Statutory authorization of ECCC (Emergency Care Coordination Center) and ECCC Council of Emergency Medicine
  • Health and Human services annual report to Congress on ECCC activities, with focus on emergency department crowding, boarding and delays in ED care following presentation
  • Emergency care/trauma regionalization pilot project grants
  • Trauma stabilization grants
  • Health and Human Services incentive payments to states that establish medical liability reforms (Certificate of Merit/early offer)
  • Health and Human Services demo project to reimburse private psychiatric hospitals that provide EMTALA services to Medicaid beneficiaries

The American College of Emergency Physicians has worked diligently to represent emergency physicians and emergency patients throughout this volatile process. As the process continues toward final legislation, ACEP will continue to focus on the needs of emergency patients, future emergency patients, and the physicians who care for them.

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Encouraging Signs for Emergency Medicine

ACEP's Washington, DC Staff

ACEP's Washington, DC Staff

It is 2009 and we have a new administration, new impetus for health care reform and new hope for meaningful change. It seems everyone agrees that the current system is not sustainable, but that seems to be all anyone agrees on. Everything else is anybody’s guess.

ACEP has worked hard to include emergency medicine in the current debate. It has been a struggle, but fortunately, the ACEP-supported “Access to Emergency Medical Services Act of 2009” enjoys bipartisan support in the House and Senate. More than 120 legislators are now co-sponsors and ACEP continues to working closely with key legislators and their staffs to promote the legislation.

One very positive note was passed on by ACEP’s Washington, DC office yesterday. Legislative staff in the House and Senate have said that various provisions of the bill have been submitted to the committees writing the health care reform bills. That is very good news and it looks like the work of the thousands of ACEP members who have called, written and visited their members of Congress is starting to pay off.

Their efforts are part of a comprehensive three-pronged approach. First, there is a strong direct lobbying campaign on Capitol Hill by ACEP staff members, including Brad Gruehn, Jeanne Slade and Gordon Wheeler. This dovetails with a grass roots lobbying campaign supported by the 1350 members of the 911 Legislative Network. These ACEP and EMRA members have developed relationships with their Senators and House members and contact them regularly to relate ACEP’s positions on legislation and regulatory initiatives. In addition, hundreds of other ACEP and EMRA members have participated in ACEP’s “Contact Congress Campaign” and are demanding that emergency medicine’s issues be addressed in upcoming reform legislation.

The third part of this approach, and a key piece of ACEP’s ability to influence the debate, is the National Emergency Medical Political Action Committee, better known as NEMPAC. This ACEP-supported organization is now one of the top-five medical specialty PACs in the country, and contributes more than $2 million per election cycle to federal legislators who support emergency physicians.

Change comes slowly in Washington, DC. But ACEP will continue its decades long work to make sure that when a bill is put on the President’s desk for his signature, the concerns of emergency physicians will be included.

CMS establishes new Toolkit, PQRI helpline

On the regulatory front, CMS recently posted 2009 implementation advice for the 2009 Physician Quality Reporting Initiative (PQRI).

Tools include a downloadable numerical listing of all codes included in the 2009 PQRI for incorporation into billing software, and a link to measure-specific worksheets for reporting each measure. CMS has also established a new help line for PQRI participants with questions regarding participation procedures, feedback reports, and bonus payments. The telephone number is 866-288-8912, and will be in operation between 7:00am and 7:00pm Central time.

CMS plans to create a new email address for inquiries as well. Additional information about these tools and the PQRI program may be found at the CMS PQRI Web site.

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Health Care Reform Takes Center Stage

Rep. Bart Gordon at ACEP's Leadership and Advocacy Conference

Rep. Bart Gordon at ACEP's Leadership and Advocacy Conference

Democratic leaders in the House and Senate released their long-awaited health care reform plans on June 9. The House released an outline that three major committees will work off of, while Senator Edward Kennedy (D-MA) released a full bill. Senator Max Baucus (D-MT), the other leading architect of reform legislation is expected to put out a bill before the end of June.

One of the key provisions of the Kennedy plan is a requirement that every person in America have health insurance. The legislation also creates a government run insurance program that would compete directly with private insurance companies. But as emergency physicians know, access to health insurance does not always equate to access to health care. If the primary care docs do not accept new patients with government insurance because of low reimbursement rates, they will eventually present in the emergency department.

ACEP’s Washington office– headed by Gordon Wheeler – has been working with the House and Senate committees responsible for developing health care reform legislation with the goal of assuring that emergency medicine’s issues are being addressed. In addition, ACEP recently launched a letter writing campaign urging members to contact Congress and demand that emergency patients’ needs are included in health care reform.

 ACEP is having some success in bringing emergency medicine’s issues to the attention of Congress, Mr. Wheeler said, and Senator Kennedy’s bill, “The Affordable Health Choices Act,” includes several provisions important to the specialty, including:

  • Reauthorization of the emergency medical services for children program ($25 million in 2010, to $30.3 million in 2014)
  • Design and implementation of regionalized systems for emergency care
  • Competitive grants for regionalized systems for emergency care response
  • Support for emergency medicine research
  • Mental health assessments, crisis intervention, counseling, treatment, and referral to a continuum of services, including emergency psychiatric care¸ community support programs, inpatient care, and outpatient programs.

In addition, Rep. Bart Gordon (D-TN), House sponsor of the “Access to Emergency Medical Services Act of 2009” (H.R. 1188) said recently that he would like to see language from that bill included in the House’s health care reform legislation. Rep. Gordon said that all of the bill’s provisions (listed below) should be considered:

  • The creation of a national bipartisan commission to examine factors that affect the delivery of care in emergency departments
  • The need for additional resources in support of emergency care delivery
  • The development of standards, guidelines and measures by the CMS to address boarding and ambulance diversion

Rep. Gordon is also encouraging the development of pilot programs to model effective and efficient trauma regionalization systems, especially in dealing with capacity and diversion issues. Rep. Gordon, a long time supporter of emergency medicine, is also concerned about emergency medicine workforce issues and reimbursement for emergency medical services. He recently sponsored “The Health Care Safety Net Enhancement Act of 2009” (H.R. 1998), a bill that would improve access to emergency medical services and provide liability coverage for emergency physicians when providing care to EMTALA patients.

Rep Gordon is also the sponsor of “The Medicaid Emergency Psychiatric Care Demonstration Project Act of 2009,” (H.R. 1415) legislation that would fund a demonstration project that allows Medicaid to pay for emergency psych services at non-publicly owned or operated institutions. The goal of the project is to help alleviate the psych bed shortage and move patients out of the emergency department and into treatment.

Debate on the numerous bills being discussed is expected to begin in July. At this juncture, it is unclear what the final health care reform legislation will look like, or if comprehensive health care reform will be successful this time around. ACEP will continue to lobby for emergency medicine’s interests and seek solutions to the critical problems confronting the specialty. This blog will continue to keep you informed of ACEP’s progress.

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