ED Violence, Due Process, Medicare Cuts: Lobbying on the big three issues in D.C.
For a number of Virginia emergency physicians, the start of last week was spent at the ACEP Leadership & Advocacy Conference in Washington D.C.
Virginia emergency physicians discuss their plans for virtual Capitol Hill visits this week at the ACEP Leadership & Advocacy Conference.
Virginia emergency physicians are in a unique position among most ACEP chapters at this particular conference. Our geographic proximity to the nation’s capital offers the ability for many Virginia doctors to attend and bring our state-level expertise to national-level issues. While the focus was on federal legislation, Virginia has seen its own share of similar concerns.
“The national issues dovetail with things that are also important in Virginia,” said VACEP Executive Director Sarah Marshall, “which meant that our people are really well informed about these issues and can speak to them on a federal and state level.”
On Monday, several legislators spoke to emergency docs, including U.S. Senator from Virginia Tim Kaine, who discussed next steps in the Lorna Breen Act, his sponsored and signed legislation that aims to reduce and prevent suicide, burnout, and mental and behavioral health conditions among healthcare professionals. Another panel featured VACEP President Todd Parker, MD, FACEP and our government affairs partner Aimee Perron Seibert, who shared with attendees the Medicaid Downcoding issue in Virginia and their efforts to ensure fair pay for EPs.
Tuesday was the big day at the conference: virtual Capitol Hill meetings with legislators (virtual due to preferences with legislative staff). Virginia emergency physicians pushed three key measures with members of Congress, “and all of the issues we lobbied are fairly well aligned with VACEP’s own priorities,” Marshall said. Learn more about each issue, and grab a free downloadable one-pager that will educate you on each topic.
1. Workplace Violence.
The emergency department has become one of the top workplaces at risk for violence. In 2018, seven in 10 emergency physicians told ACEP that ED violence had increased over the previous five years. Since then, workplace violence has become an even greater threat, exacerbated by the various stresses and challenges of the pandemic.
“We’ve talked to so many of our members in recent months who have faced workplace violence and we were able to share some very personal stories with legislators on Tuesday,” Marshall said. “There was one line we kept coming back to, which is, ‘If workplace violence continues, and the emergency department is not a healthy and safe workplace, doctors and staff will leave and the healthcare safety net goes away.’ Workplace violence jeopardizes our ability to care for people.”
Members with U.S. Senator from Virginia Timothy M. Kaine. Kaine sponsored the Lorna Breen Act, which aims to reduce and prevent suicide, burnout, and mental and behavioral health conditions among healthcare professionals.
2. Due Process.
If you see something, can you say something…safely?
The right to Due Process provides the foundation for a fair, equitable, and supportive environment, ensuring emergency physicians can fully advocate for their patients without fear of retribution or termination by employers.
However, because many emergency physicians are employed by a contract group and not the hospital in which they work, a scenario is created where one set of hospital-employed doctors has due process protections and the other set does not.
This leaves many emergency physicians uniquely vulnerable to unfair disciplinary or retaliatory practices, as they are not protected by and subject to the same medical staff bylaws that cover directly employed physicians. A hospital or facility can request that the ED group terminate an emergency physician without due process, or simply remove them from the schedule, thus limiting—or effectively ending—an emergency physician’s ability to continue their career.
In their virtual visits, VACEP members urged legislators to cosponsor the forthcoming “ER Hero and Patient Safety Act.” This would guarantee due process protections for emergency physicians, ensuring that those who provide our nation’s health care safety net can effectively advocate for patients without fear of retaliation or termination.
3. Medicare cuts.
VACEP urged lawmakers prevent more cuts to Medicare payments to emergency physicians. These payments continue to drop; the Centers for Medicare and Medicaid Services (CMS) 2021 fee schedule finalized a cumulative 6% cut to emergency medicine reimbursement. That will jump to 9% on January 1 without congressional action.
In addition to advocating for fair Medicare pay at the federal level, VACEP President Todd Parker, MD, FACEP and our government affairs partner Aimee Perron Seibert were on a panel to discuss the Medicaid Downcoding issue in Virginia. The two have led the effort to ensure fair pay for EPs across the Commonwealth.
Rather than a yearly scramble to address steep payment cuts, emergency physicians are asking for the opportunity to work with Congress to identify policies to provide long-term stability for Medicare beneficiaries and their physicians.
“Lower pay makes it more difficult for doctors to stay employed,” Marshall said. “This is another safety net issue. It’s not like the education to become a doctor gets cheaper, so they end up with more debt and less pay.”
