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.

The FTC approved a rule banning non-competes in April, a decision celebrated and supported by ACEP. The rule not only prohibited nearly all non-competes, it required employers to notify all current and former workers subject to a non-compete that their non-compete is no longer enforceable. The rule would have gone into effect in early September.

However, a federal judge issued a nationwide injunction in August, preventing the FTC from enforcing this new rule.

ACEP urged the FTC to promptly challenge this decision. As burnout rates and staffing constraints impact emergency departments nationwide, restricting physicians’ job options only weakens our health care safety net. The fight to preserve physician autonomy must continue and must include promoting, not limiting, viable career choices.

ACEP Celebrates 50 Years with EMRA

Since inception, ACEP and EMRA have been independent organizations, each dedicated to advancing the specialty and advocating for every emergency physician, EM physician-in-training, and EM-bound medical student. As ACEP reflects on the incredible accomplishments of the partnership, ACEP acknowledges and appreciates each organization’s unique contributions.

In a September statement, ACEP emphasized its commitment to EMRA and desire for more decades of working with EMRA.

Both organizations recognize that a strong ACEP and a strong EMRA—as well as a unified and collaborative ACEP-EMRA relationship—are essential for the future of emergency medicine.

This year marks a significant milestone as EMRA celebrates 50 years of incredible growth and achievement, as well as the strength and maturity of the organization. In the statement, EMRA expressed its gratitude for ACEP and the decades of support that have helped develop EMRA into the organization it is today, growing from a startup group of passionate residents to a major voice in the medical community.

ACEP is proud to exclusively partner with the only fully independent resident organization in emergency medicine to together provide the highest quality of support, resources, leadership opportunities, and advocacy for our shared members.

ACEP Members Save a Life at DFW Airport

From L-R: Andrew Koons, DO, FACEP; Sarah Bilski, DO; Irtaza Assar, DO; Rachel Armstrong, MD; Taylor Stavely, MD

Standing in the TSA line at Dallas-Fort Worth International Airport became suddenly eventful for ACEP members traveling home from ACEP’s Teaching Fellowship in August.

Andrew Koons, DO, FACEP; Sarah Bilski, DO; Irtaza Assar, D; Rachel Armstrong, MD; and Taylor Stavely, MD, jumped out of line when they heard a woman scream for help and saw a man had collapsed. They immediately called 911, asked somebody to find an AED and started chest compressions.

“There wasn’t really a crowd, probably because we do this all time in the ED and remained pretty calm,” Dr. Bilski said. “We didn’t have an AED—it didn’t arrive by the time we were done—but we were able to bring him back.”

The 53-year old traveler opened his eyes, sat up and was able to hold a conversation with the doctors. He told them he had never had any heart problems and definitely never had a heart attack. “We told him, ‘Well, you have now.’”