Alison Smith, MD, MPH
Each spring, ACEP holds a Legislative and Advocacy Conference (LAC) in Washington, DC. At this conference, hundreds of emergency physicians from around the nation, including a delegation from Utah, participate in educational advocacy and leadership seminars and forums for two days and then go to Capitol Hill for a day to inform our legislators about issues affecting emergency medicine and patient care. Due to COVID, this year’s LAC could not be in person, but instead was held virtually. Drs. David Mabey, Forrest Wells, Jordan Mabey, Sean Slack, and I had four 30-minute calls with Senator Mike Lee and legislative aides for Rep. John Curtis, Rep. Chris Stewart, and Senator Mitt Romney regarding four timely emergency medicine topics.
First, we emphasized the importance of sufficient PPE procurement for frontline healthcare personnel in Utah and the need for a coordinated and centralized effort to ensure that workers responding to the pandemic are protected. We promoted protecting the rights of emergency physicians to wear and use PPE, even if provided by themselves rather than their hospital system, as well as full use of the Defense Production Act and depletion of the Strategic National Stockpile to make sure PPE moves through production and to the bedside where it is needed.
Second, we advocated for protection for emergency physicians and other health care professionals from medical liability during the time of COVID except in cases of gross negligence or willful misconduct. One proposal was for Congress to extend broad civil immunity to physicians and other clinicians for any alleged injury or death while they are providing medical care in response to the COVID pandemic. Another suggestion was to extend Federal Tort Claims Act liability protections for physicians and other clinicians when they provide care to COVID patients or who otherwise are responding to government guidance or protocols.
Next, we urged consideration of hazard pay for emergency physicians and other frontline personnel who are risking their lives every day as we continue to see patients in EDs across the country, often without adequate PPE, screening, or testing. We asked that for emergency physicians, this fund allow us to qualify for hazard pay of up to $25,000, paid directly to individual physicians using their National Provider Identifier (NPI).
Finally, we applauded Congress’ support in protecting patients by waiving cost-sharing and mandating coverage by insurers for COVID-19 tests and testing-related services. We asked, however, that Congress also mandate that health plans cover all COVID care, including both testing and treatment, without patient cost-sharing and with appropriate reimbursement to the clinicians for all services rendered. We stressed that immediate federal financial resources and support separate from what is provided to hospitals is needed given severely decreased reductions in volume of patients across the country since the start of the pandemic. It was emphasized that sole reliance on the CARES Act Provider Relief Fund, which must be shared by hospitals, physicians, and all other health care professionals, and Small Business Administration loans that have already run out of money once will not be enough. We also encouraged our legislators to defer long-term discussions on surprise billing until after we have finished providing care for the initial wave of COVID patients so that we collectively have time to thoroughly deliberate and consider the best way forward.