One proposal in the legislation was to create an alternative pathway for general practitioners to become certified as emergency physicians based on 10 years working in an emergency department, and not based on completion of the training, residency, and board-certification programs required for emergency physicians. ACEP is a strong proponent of the pathway to board certification through training and residency with a certification issued by the American Board of Emergency Medicine (ABEM) or the American Osteopathic Board of Emergency Medicine (AOBEM).

Puerto Rico ACEP responded with a comprehensive advocacy campaign that included grass roots, coalition outreach, direct lobbying, and earned media to push against the legislation. Puerto Rico ACEP and national ACEP sent individual letters to the senate president and the presidents (chairs) of the senate and assembly health commissions (legislative committees) formally expressing opposition to the legislation. Cesar Andino-Colon, MD, FACEP, raised awareness of the problems in the legislation, participating in several public-affairs television programs and amplifying the reach of those appearances through social media.

ACEP reached out for national organizational support, including to the American Board of Medical Specialties (ABMS) among others. The outreach generated additional advocacy and letters of opposition. The ABMS provided additional support and guidance to ACEP’s public-relations staff on hiring a contract lobbyist. ACEP was able to coordinate a written public statement by a newly formed coalition of 38 medical specialties and subspecialty organizations with the Puerto Rico College of Physician and Surgeons, and national organizations abroad sent statements that the chapter was able to make public strategically in coordination with the organizations.

The groundswell of opposition to the legislation led to the bill being pulled from consideration before a hearing could be held in the senate’s health commission. Read more details at acep.org/puerto-rico-win.

Indiana Bill Requires Hospital EDs to Have Physician Onsite

Signed into law this May by Indiana Governor Eric Holcomb, SB 400 is a comprehensive health care bill that includes reforms to physician credentialing and prior authorization, among other items. The language proposed by Indiana ACEP and passed into law requires a hospital with an emergency department to have at least one physician on site and on duty who is responsible for the emergency department at all times.

Indiana ACEP was directly involved in the legislative process from the start. Emergency physician expertise and support was instrumental in developing the language and rallying support for the new law.