Updates from ACEP17

November 02, 2017 2:44 PM | Sally Winkelman (Administrator)

By Lisa Maurer, MD
WACEP Board of Directors 

For two days before the Scientific Assembly, councilors from each state meet to discuss proposed ACEP policy.  Some new topics of ACEP policy just approved include:

  1. Work to prevent abrupt changes in ED contract groups 
  2. Supporting paid parental leave and work on producing best practice guidelines for how to actually implement this fairly in various EM practice environments
  3. Increase resources (read: money) to promote EM physician wellness and workforce diversity 
  4. As oxy abuse transitions to heroin abuse, support development and study of supervised injection facilities that although controversial in some ways, have been successful in other countries.

Then during Scientific Assembly, I was able to do lots of work on policy issues pertinent to our Wisconsin's efforts.  Ongoing projects include:

  1. Medicaid reforms, including reimbursement.  As states get more flexibility, ACEP is considering drafting model Medicaid reform legislation, and then selecting a state that could utilize national ACEP resources to push through legislation. I know what state I'll be volunteering for the pilot!
  2. Fighting unfair legislation on out-of-network balanced billing.  In many states, groups are getting squeezed out of contracts by unfair compensation, then state legislatures are banning balanced billing.  This is creeping into WI, and WACEP is working with PFC to be proactive. Check them out: http://thepfc.org/the-issue/
  3. Lots of insurance companies are starting to implement policies that try to limit "non emergent" visits, often by refusing to pay claims for visits they retrospectively consider non emergent based on the final dx.  This is a clear violation of the prudent layperson standard, which is law for most public and private insurance companies, and it IS starting to happen in WI.  (What is the PLP standard? http://newsroom.acep.org/2017-05-16-Emergency-Physicians-Anthem-Blue-Cross-Blue-Shield-Policy-Violates-Federal-Law). Our patients will be put in a dangerous position, with increased delayed care due to fear of insurmountable out of pocket costs.  I'm working with ACEP to decide how to use their resources to fight this.  Keep me updated if you see/hear about this with patients.

Lastly, CMS director Seema Verma has declared a "Patients Over Paperwork" initiative, which looks like it may actually be more than just a headline.  Director Verma met with ACEP last week, and discussed specifics, including the decreasing EHR burdens and getting rid of MIPS.  With ACEP's new president, Paul Kivela, being a doc from an independent one-hospital group, there is a new push to focus on improving practice for docs working in the trenches.