Pushing for PPE

ACEP Policy Priority: Increase availability of personal protective equipment (PPE) for emergency physicians and other frontline personnel responding to the epidemic. Fully utilize Strategic National Stockpile to maximize dissemination of critically needed PPE.

Progress: We led a grassroots campaign that generated more than 120,000 letters to members of Congress, urging them to prioritize PPE for frontline personnel and to release of PPE in the Strategic National Stockpile. This was one of our most successful grassroots efforts ever!

ACEP found out some hospitals were sanctioning staff for wearing donated or self-purchased PPE. We discussed this problem with The Joint Commission (TJC), sharing firsthand accounts from our members, and then TJC issued a statement of support for allowing staff to bring their own standard face masks or respirators to wear at work.

ACEP is also addressing this problem with the American Hospital Association (AHA), the Centers for Disease Control and Prevention (CDC), the Occupational Safety and Health Administration (OSHA), and the Food and Drug Administration (FDA). ACEP is working with GetUsPPE.org to connect private industry with hospitals and clinicians in need.

Expanding Access to Care Through Telehealth

ACEP Policy Priority: Guarantee telehealth services can be fully utilized by removing originating site limitation under CMS telemedicine rules and allowing emergency physicians to bill for ED evaluation and management (E/M) codes.

Progress: The Centers for Medicare & Medicaid Services (CMS) has significantly expanded existing telehealth policies under Medicare in an effort to enable patients to communicate with their doctors remotely during this national emergency. The initial CMS guidance was unclear about how emergency physicians could, in fact, deliver telehealth services. ACEP was in constant contact with CMS, successfully advocating for two major CMS policy changes:

Allowing medical screening exams (MSEs), a requirement under EMTALA, to be performed via telehealth Adding the ED E/M codes to the list of approved Medicare telehealth services

Both policy changes are critical. Being able to perform MSEs via telehealth will help protect emergency physicians from unnecessary exposure to the virus and help preserve limited supplies of PPE. Having the ED E/M codes on the approved list of Medicare telehealth services enables emergency physicians to be appropriately reimbursed for the high-quality and high-intensity services they deliver remotely.

To facilitate these important changes, ACEP cohosted a webinar with CMS so our members could ask questions about the new EMTALA and telehealth policies.

Expanding Liability Protections

ACEP Policy Priority: Enact temporary liability protections for the duration of the pandemic for health care professionals who are screening and treating COVID-19 patients.

Progress: On behalf of every emergency physician who may be forced to make difficult or impossible treatment decisions during this pandemic, ACEP is actively working to secure immunity from liability. ACEP President William Jaquis, MD, FACEP, explained the need for increased liability protections in a meeting he had with Vice President Mike Pence and other Trump administration officials and we are working directly with Congressional lawmakers to include liability protections in future COVID-19 legislation.

A lot of the liability movement will happen on the state level, so we provided a template letter asking for full immunity to every state chapter.

To date, New York, Illinois, Massachusetts, and Connecticut have made declarations that have included strong liability protections for frontline health care practitioners. Several other states have indicated that they believe statutes related to declared emergencies provide this protection. A couple of other states have indicated that the governors do not believe they have authority to do this. There is political momentum on this issue, and ACEP believes we will see this addressed in many more states soon.

Medical liability reform has always been a priority for ACEP. When we’re on the other side of this pandemic, we will make the case that liability protections are still appropriate after the crisis.