President's Letter
Charles C. Scott, MD, Phd, FACEP
I would like to thank everyone for their support and for coming to the dinner at the ACEP Denver Scientific Symposium. We continue to face challenges to our practice of medicine, our patients having access to us, and the complicated landscape of reimbursement for the care we provide. Recently, the Arkansas Medical Society (AMS) had a meeting with the regional and state leaders of most medical specialties with me representing Emergency Medicine. They are mainly focused on scope of practice, such as optometrists now able to do surgery, as well as many legislative issues regarding APNs, CRNAs, acupuncturists, chiropractors wanting to practice independent of the state medical board, and full prescription privileges. I have also recently given a radio interview with KSER about surprise billing, and we have a lot of support with people who understand these issues.
We, as board certified emergency physicians are somewhat insulated from these battles, as not as many fields are fighting to provide care without any guaranty of reimbursement 24/7/365. We share many of the same hurdles but have our own and the AMS may be willing to help. We will likely still be fighting for fair reimbursement, given the “surprise billing” legislation now at the Federal level. ACEP has developed, and New York state has started an Independent Dispute Resolution process that is protecting reimbursement for Emergency care. They have a process whereby both the billing company and insurance company put forth what they think is a fair amount for the services provided. The dispute resolution is performed by an independent party that has 30 days to determine which number to choose. The dispute resolution is only able to choose one of the two numbers, which incentivizes billers and insurance companies to be more reasonable.
I would ask if anyone knows their state legislator and would feel comfortable asking them to introduce a bill in 2021 to institute this same process in Arkansas, please let me know and we can reach out to our legislative advocacy experts to move this process forward. In New York State, out of 7.5 million Emergency patient visits, only 849 went to dispute resolution (0.01%), and they were decided about half and half. If the current legislation passes, the out-of-network rates would be set by CMS, which is typically led by an insurance company executive and projections are for a 30% drop in reimbursement rates. This will put even more pressure on our hospitals, causing many to close, cut back emergency physician hours, and decrease Arkansan access to emergency services.
Please also visit protectemergencycare.org for more information and feel free to tweet and put it on Facebook.
If you’ve ordered a head CT recently, you may have seen the new software tools that are supposed to decrease imaging by requiring you to click through “appropriate use criteria.” I would label this a “patient care delay tool.” ACEP has a sample letter you can send to our CEO and IT departments. You can go to, download and use the letter here.
December 6th, we have our Chapter Annual Meeting at SO Restaurant. I encourage you to attend. More details are listed below. We have two new medical schools, and I propose we create non-voting medical school representation from each medical school on the board to further outreach and recruiting to our field.
I appreciate your patience with the length of this letter and thank you for being a part of ACEP!
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