A Newsletter for the Members of the Delaware Chapter - Winter 2020

John Powell, MD, MCHDS, FACEP

President

Sherrill Mullenix

Executive Director

302.733.1919 | Website

From the President

John Powell, MD, MHCDS, FACEP

Happy quasi-winter! Spring break escapes are around the corner, although our recent weather has afforded plenty of opportunities for enjoying the outdoors locally. I hope you are happy, well and spending time with family and friends.

National Update

We continue to engage on the national front regarding out-of-network billing, aka “surprise bills”. We were concerned that Congress would push through out-of-network billing legislation as part of an end-of-year omnibus spending package, which would have circumvented our ability to influence the process. Fortunately, this did not occur. There is, however, an enormous bipartisan push to pass out-of-network legislation by May 2020. Of the competing packages, National ACEP has endorsed the most recent bill version produced by the House Ways & Means Committee, which includes a mediation process without a minimal qualifying bill amount to trigger the process.

Out-of-network billing will likely be the primary discussion point during our Hill visits as part of the ACEP’s Leadership & Advocacy Conference this April 26-28. Consider signing up and joining us and representatives from all state chapters to learn about national legislative issues and to lobby Congress directly to preserve our interests.

If pressed for time, join us on Tuesday April 28th for the Lobby Day, when we meet with our senators, representative and their staff. You may register through the ACEP website.

State Update

Similar to the national front, out-of-network billing has become germane to Delaware. Balance billing for emergency services is already banned in Delaware; however, the Delaware process includes an arbitration mechanism and direct payment of funds to providers during arbitration.

House Bill 286 seeks to expand the out-of-network provisions to non-emergency providers. We will remain engaged to ensure that the current provider protections remain intact.

In addition to activities in Delaware, Dr. Emily Granitto rallied our DE ACEP members who live in Pennsylvania to assist PA ACEP with PA House Bill 1862, a balance billing proposal that employs a benchmarking methodology versus an arbitration pathway. This would adversely affect emergency care in Pennsylvania. Many thanks to our members who participated in those discussions and wrote letters to their legislators.

Chapter Updates

Plan to attend the next Delaware ACEP meeting, March 10th at Cantwell’s Tavern in Odessa. Cocktails begin at 1800, dinner and meeting start at 1830.

Nemours AI DuPont Hospital will host their annual “Pediatric Emergency Skills Course for Emergency Physicians” on May 7th. I attended the course last year, and it was phenomenal! DE ACEP has sponsored ten of our members to attend in the past, which will be a discussion point at our March meeting. Register for the course.

Please call me or Emily Granitto at any time with questions, concerns or if you would like to get involved in particular issues in our state. We wish you all the best as you continue to work each day to serve our patients and provide the highest level of compassionate emergency care.

Welcome New Members!

Douglas R Ader, DO

Emily E Bollinger

Cortnie Carlheim, DO

Sergiu Costinas, MD

Paula Andrea Diaz, DO

Matthew Dillon, MD

Joshua T Drake, MD

Andrew Freeman

Parth S Gandhi, DO

Aamer Arif Khan, MD

Sahar Khan, MD

Eric Lieu, MD

Christopher J Parronchi, MD

Niketu Patel, MD

Tulsi Patel, MD

Alana Payne

Matthew J Rizzotti, DO

Elizabeth Grace Shanahan, MD

Mary K Voelker, DO

Diane Yuan Wang, MD

Lynda X Yu, MD

FROM NATIONAL ACEP

Articles of Interest in Annals of Emergency Medicine - Winter 2020

Sam Shahid, MBBS, MPH

Practice Management Manager, ACEP

ACEP would like to provide you with very brief synopses of the latest articles and articles coming soon to Annals of Emergency Medicine. Some of these have not appeared in print. These synopses are not meant to be thorough analyses of the articles, simply brief introductions. Before incorporating into your practice, you should read the entire articles and interpret them for your specific patient population. View synopses here.

Annals Supplement: Social EM

Want to know more on social determinants of health? Check out the special, open-access Annals of Emergency Medicine supplement "Inventing Social Emergency Medicine: A Consensus Conference to Establish the Intellectual Underpinnings of Social Emergency Medicine."

New Policy Statements and Information Papers

The following policy statements and information papers were recently approved by the ACEP Board. For a full list of the College's current policy statements, consult the ACEP Policy Compendium.

New Policy Statements

Pediatric Readiness in Emergency Medical Services Systems

Opposition to Copays for Medicaid Beneficiaries

Revised Policy Statements

Firearm Safety and Injury Prevention

The Role of Emergency Physicians in the Care of Children

New Information and Resource Papers

Information and Resources Addressing Falsification of Data in Research

Resources on Behavioral Health Crowding and Boarding in the Emergency Department

Announcing the new ACEP Clinical Alert

Keep up with the latest physician guidance and clinical updates from the CDC with the ACEP Clinical Alert online.

Need a Card That Says You Exceed the Need for a Merit Badge?

ACEP believes that certification by ABEM or AOBEM supersedes the need for so-called “merit badge” short courses and opposes such requirements for board certified EPs. Many credentialing bodies, however, still require physicians to produce evidence of completion of the short courses. For members required to have such a card, ACEP offers its members a set of personalized cards online.

NEMPAC has your back in the 2020 Elections

2020 is an important election year. This is no time to sit on the sidelines! NEMPAC is working hard to ensure the concerns of emergency medicine and patients are front and center with candidates running for federal office. Your support this year will make our voice stronger to help elect emergency medicine supporters in Congress and identify and cultivate future champions. The NEMPAC Board of Trustees and staff have put together an informative presentation on NEMPAC’s role in the 2020 elections and how decisions are made to support candidates. Click here to view the presentation and click here to support NEMPAC today.

Update on ACEP’s APM Strategic Initiative

ACEP has an exciting update on our Alternative Payment Model (APM) Strategic Initiative. As background, a couple years ago, ACEP created the Acute Unscheduled Care Model (AUCM), a Medicare APM specifically designed for emergency physicians. Currently, individual emergency physicians and emergency medicine groups do not have any opportunities to directly participate in “Advanced APMs.” Under Medicare, participation in an Advanced APM could result in a five percent payment bonus through 2024 and a higher payment fee schedule update starting in 2026. The AUCM has been endorsed by the Secretary of Health and Human Services (HHS), but not yet implemented by the Centers for Medicare & Medicaid Services (CMS).

As ACEP waits to see how CMS may implement the AUCM in Medicare, we are simultaneously pursuing model implementation by other payors, including Medicaid and private payors. More and more state Medicaid agencies and private payors are moving away from fee-for-service (FFS) contracts with physicians and other health care practitioners towards value-based payment arrangements, and the AUCM is an ideal APM construct for these payors to pursue for emergency medicine.

Through the APM Strategic Initiative, ACEP is continually providing information and resources to emergency medicine groups, state Medicaid agencies, private payors, and other stakeholders about how to structure and participate in emergency-medicine focused APMs that use the AUCM as a framework. We are happy to announce that we have updated our APM Strategic Initiative website with additional resources that provide a more detailed overview of the AUCM and its potential for improving emergency care and reducing costs.

While these resources are mainly background materials for you to learn more about the AUCM, ACEP is in the process of developing targeted tool kits that you can use to engage in discussions with state Medicaid agencies and private payors on emergency-medicine focused APMs. Stay tuned for this next phase of the initiative.

Concerned About Opioid Use? $500k ALTO Demonstration Grants for EDs

SAMSHA released a grant opportunity for the Emergency Department Alternatives to Opioids (ALTO) Demonstration Program designed to expand non-opioid treatment protocols in emergency departments throughout the country. Applications are due March 17.

Nominate Your Peers, Med Students and Faculty

Nominations are open for the 2020 ACEP Leadership & Excellence Awards, honoring members who distinguish themselves for leadership and excellence in EM. Submit nominations in one or more award categories by March 1. Awards for the ACEP/EMRA Medical Student Professionalism and Service Award and ACEP faculty awards are both due by April 15.

Until Help Arrives

The first few minutes after a major medical emergency are critical for survival, and emergency personnel aren’t always the first ones on the scene. To educate the general public on basic life-saving skills, the American College of Emergency Physicians (ACEP) created Until Help Arrives, a one-hour training course taught by emergency physicians in their local communities. Learn more.

Free Counseling Available for ACEP Members

Receive exclusive access to 3 free counseling sessions through ACEP’s new Wellness & Assistance Program. Support is available 24/7, & you can conduct your sessions over the phone, face-to-face, via text message or through online chat. Learn more.

Be Accredited to Provide Pain & Addiction Care in the ED

Show your community that your ED is part of the solution. ACEP will soon launch the Pain & Addiction Care in the ED (PACED) Accreditation Program, developed for EM physicians by EM physicians. It will provide the education, tools & resources you need to provide better care for patients in pain & those with substance misuse.

Registration Is Now Open for ACEP’s 2020 Leadership and Advocacy Conference

Advocate for your specialty, engage with new Members of Congress and connect with EM leaders at ACEP's Leadership & Advocacy Conference (LAC) - April 26-28, 2020 in Washington, DC. Register today with promo code CAPITOL to save $75* and make your voice heard! Hurry – the hotel always sells out fast. https://www.acep.org/LAC

Delaware Chapter ACEP

4755 Ogletown-Stanton Road

Newark, DE 19718

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