ACEP Adds Comment to CMS, Responds to the CY 2025 OPPS Proposed Rule

In addition to a thorough and comprehensive letter responding to the CY 2025 Medicare Physician Fee Schedule proposed rule, ACEP submitted two letters last month in response to the CMS CY 2025 Outpatient Prospective Payment System (OPPS) proposed rule. The first letter ACEP submitted on behalf of emergency physicians emphasized that a fifth consecutive year of reductions in Medicare physician payments is unacceptable. The Proposed 2025 Medicare Physician Fee Schedule is expected to be released on or around Nov. 1, 2024—with an effective date of Jan. 1, 2025.

In the recent follow up, ACEP is proposing to have CMS enhance the existing emergency services Condition of Participation (CoP) to add a requirement for hospitals to have a plan or protocol on file for when the number of patients boarding in their ED exceeds a particular threshold—then enact when the trigger is reached.

ACEP has been pushing CMS for almost two years to create a new CoP related to boarding. Noticing that the agency was proposing additions to the existing emergency services CoP in this year’s proposed OPPS rule, ACEP decided to push for boarding to be added to their new language.

CMS’ overall intent with the proposed modification was to expand access to maternal care, especially in rural areas, but because of how their changes were structured and approached, it opened the door for ACEP to address boarding.

ACEP worked with several boarding experts on a proposed approach for a boarding CoP and met with The Joint Commission for technical feedback. In addition to including a proposal in ACEP’s overall OPPS response, the College also developed a separate letter to CMS on this change and solicited outside groups to sign.

Also included in ACEP’s overall OPPS response letter, among others:

• Support for CMS’ proposal to separately pay for the use of non-opioid alternatives for pain management, and encouragement to expand this policy going forward to extend it to the ED setting.
• Feedback on three new measures on health equity and social determinants of health proposed by CMS.
• Caution against public reporting of the Psychiatric/Mental Health Patients stratum of the Median Time for Discharged ED Patients that CMS has proposed.

ACEP Urges FTC to Challenge Harmful Ruling on Non-Competes

ACEP issued a statement in August, expressing deep disappointment by the decision to block the Federal Trade Commission (FTC) ban on non-compete agreements. Non-compete agreements limit the right of emergency physicians to freely practice medicine in their communities. Our efforts to eliminate these harmful, predatory and coercive clauses will not stop.