A look back at VACEP's '23 wins
Virginia’s ACEP Councillors and Board members at ACEP Council in Philadelphia.
It was a big year for Virginia’s emergency medicine community. From activity across the Commonwealth to meetings in D.C. and Philadelphia, Board members and other VACEP volunteers put in thousands of hours advocating for emergency medicine, amounting to hundreds of thousands of dollars worth of donated time.
We have more in store for 2024, and we’ll outline that agenda for members in the days to come.
For now, as we close out 2023, here’s a look at VACEP’s achievements over the last 12 months:
KEEPING YOU AND YOUR TEAMS SAFE: 24/7 TRAINED ED SECURITY
We introduced and passed a first-of-its-kind bill in the 2023 General Assembly, requiring off-duty police or security officers trained in de-escalation and restraint in every ED 24/7. This law has already become a model for other states; North Carolina passed a law modeled after ours this summer. Here’s more.
KEEPING PATIENTS SAFE AND GIVING PARAMEDICS MORE RESPONSIBILITY: UPHOLDING SCOPE OF PRACTICE
We prevented NPs from gaining the ability to practice independently with only two years of training. We successfully kept training to five years/9,000 hours of supervised training before a Nurse Practitioner can apply for independent practice.
We helped pass a bill allowing paramedics to administer medications in an ED within their scope of training.
ENSURING FAIR REIMBURSEMENT: ENDING DOWNCODING
We fought for fair reimbursement for treating Medicare patients. For three years, we opposed a harmful Virginia DMAS and CMS “Downcoding” policy in the state budget that reduced 790 of the most common ED diagnoses to a Level 1 reimbursement of $15 (more at vacep.org/downcoding).
This policy cost Virginia ED groups millions annually, and thanks to VACEP and our partners’ efforts, it was repealed this year. We are working to reimburse emergency physicians for charts downcoded since the policy went into effect in July 2020. That total? Millions.
The repeal of the provision was due to a 2020 federal lawsuit, filed in Virginia by the College and partners, that challenged the Downcoding provision. This year, ACEP Now published a piece co-authored by VACEP President Todd Parker, MD, FACEP that recapped the legal underpinnings of the case and why the ruling stands as persuasive authority for other potential plaintiffs challenging “restrictive diagnosis” lists by commercial and Medicaid health plans.
LIMITING BUREAUCRACY: IMPROVING MEDICAL TDOS
VACEP leaders advocated for improvement to the bureaucratic medical TDO process. Legislation that passed and later became law allowed:
Emergency physicians able to get a medical TDO for intoxicated patients by allowing them to call magistrates — without calling courts first.
For a new mechanism to release a patient under a TDO when they are in the ER and waiting for a bed, but, in waiting, no longer meet the criteria of being a danger to themselves or others. Community Services Boards can be called back in to re-evaluate a patient under a TDO.
PROTECTING PHYSICIAN MENTAL HEALTH
We supported the removal of two questions on Virginia’s licensure, certification, and registration applications for doctors. These will help emergency physicians get treatment for mental health conditions without fear of repercussion. The questions were:
Do you have any reason to believe that you would pose a risk to the safety or well-being of your patients or clients?
Are you able to perform the essential functions of a practitioner in your area of practice with or without reasonable accommodation?
Our Issues page outlines the core areas in which we advocate for emergency medicine. Yet as importantly, remaining a VACEP member provides networking, personal and professional development, and relationships with emergency medicine leaders from a variety of practice environments.
