ACEP state advocacy impacts the lives and careers of every emergency physician, every day. ACEP chapters continue to tally state legislative and policy wins by sharing their experience with public officials, and organizing bold campaigns on the issues that matter most.

The ACEP advantage is unmistakable. Chapters across the country are seeing success when they leverage the relationships and expertise that only ACEP can provide. Working together, physician advocates are making the case to protect physician leadership, address boarding, and strengthen on-the-job protections that you need and deserve. And that barely scratches the surface.

California: Stopping Insurer Downcoding

Emergency physicians are standing up to insurance companies and demanding an end to bad behaviors. ACEP, alongside CalACEP and the California Medical Association, sent a letter in July to expose Aetna’s bad behavior to the full California Congressional delegation. The letter outlined the insurer strategy to “downcode,” or lower the severity of physician and facility claims for emergency services, for commercial, Medicare Advantage, and student health policies.

Aetna could not withstand the pressure and announced it would halt these dangerous and misguided policies in California. This is a major win for California’s emergency physicians and patients, and a direct result of ACEP advocacy.

While the specific tactics mentioned in the letter are no longer a threat to practices or patients in California, Aetna has not committed to dropping these policies in any other states. The work is far from finished. ACEP will continue to expose insurers acting in bad faith and will never stop fighting for ACEP members.

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ACEP Needs to Hear From You

Are you experiencing insurance company behavior that puts you or your patients at risk? Your experience fuels ACEP advocacy across the country.

Connecticut: Increasing Hospital Accountability to Address Boarding

Sometimes, impactful change happens because of emergency physicians’ work behind the scenes. Connecticut ACEP members moved the levers of state government by participating in a boarding and crowding working group in January.

Emergency physicians helped compel the group to recommend that the Connecticut Department of Public Health develop and mandate publicly reported quality measures on emergency department boarding. The resulting metrics and dashboard are another major win for emergency physicians and patients.

This data collection and sharing will enhance efforts to increase transparency, inform public policy, and help drive the systemic solutions necessary to meaningfully address the crisis of boarding in emergency departments.

Encouraging Collaboration and Growing Stronger Together

Each chapter success inspires another, and everyone benefits when the chapters work together. Oregon ACEP heard about the success in Connecticut. Additional discussions led to the development of model legislation that the Oregon chapter expects to strongly support during the 2025 legislative session.

Whenever possible, ACEP facilitates teamwork across chapters. These unique collaborative advocacy opportunities are changing emergency medicine for the better. The scope battles unfolding across the country offer additional examples.

Indiana: ACEP-Developed Model Legislation Protects Emergency Physician Leadership

Back in 2023, Indiana’s emergency physicians helped pass a state law requiring an emergency physician to be present and on duty in every emergency department. Relentless advocacy from Indiana ACEP reinforced how critical it is for emergency physicians to be the ones in charge of emergency care teams.

ACEP-developed model legislation was a big part of that victory. Today, emergency physicians in numerous states use the model language to champion policies that support physician leaders.

Virginia: A Unique Approach to Scope of Practice

Emergency physicians are speaking out to mitigate risks that arise when nurse practitioners and physician assistants are permitted to expand their practice beyond their training. It makes all the difference when elected officials hear concerns directly from emergency physicians.

Virginia ACEP was able to strengthen the laws in its state by taking a strategic approach that they felt would resonate with their legislators. “We did not say it was about scope at all. We made it about fixing outdated legislation,” Dr. Todd Parker said during the ACEP Leadership and Advocacy Conference.

Using the ACEP model legislation, VACEP worked to create and support a law that requires emergency departments in Virginia to have a physician onsite and responsible for managing the state’s emergency departments. VACEP also utilized polling and tireless advocacy to push legislation across the finish line. The Virginia law goes into effect in July 2025. Chapters in Missouri, Ohio, and South Carolina are taking inspiration from Virginia, Indiana and others as they actively work on these same issues.

Oregon and California: Mitigating Harm from the Corporate Practice of Medicine

ACEP policy strengthened in 2023 clearly states that “any practice structure that threatens physician autonomy, the patient physician relationship, or the ability of the physician to place the needs of patients over profits should be opposed.”

ACEP firmly supports national and state efforts to address and limit consolidation and corporate investment in medicine. While ACEP continues to work with the Department of Justice, Federal Trade Commission and Congress, the battles continue on multiple levels and often land in state legislatures or courthouses.

In California, ACEP filed a brief in support of the lawsuit emergency physicians brought against Envision Healthcare and Envision Physician Services. Direct pressure from emergency physicians led to a settlement. In Oregon, ACEP supported the chapter’s passionate efforts with a letter to the legislature supporting a bill that would limit corporate ownership of medical practices in the state.

New ACEP State Legislative Dashboard Simplifies Issue Monitoring

To capture the full extent of ACEP state advocacy, a new members-only resource is available. The State Legislative Dashboard is a one-stop-shop to learn more about the issues and keep up with chapter priorities and accomplishments.

Click to see ACEP’s State Legislative Dashboard.

From coast to coast, ACEP chapters are indispensable allies. These battles will undoubtedly continue and ACEP will be there supporting individual emergency physicians every step of the way.