Advocacy

EDPMA advocates for emergency department physician groups and partners to enhance quality patient care through operational excellence and financial stability.

EDPMA is the voice of Emergency Department practices before Congress, CMS, state-level decision makers, and private payers on Medicare and Medicaid Reimbursement, Quality Reporting, Documentation Requirements, Provider Enrollment, and more. We keep our members up to date with newsletters, interactive committee meetings, regular email alerts, and social media posts—helping your business succeed in this every-changing landscape.

We urge you to become an advocate for the Emergency Department business. Here is an advocacy primer to get you started: EDPMA Advocacy Primer.

As of October 2023, EDPMA:

• met with staff of 6 members of Congress in leadership roles in committees of jurisdiction for our issues
• met with CMS and CCIIO leaders
• sent 19 letters to CMS/CCIIO and the Senate HELP Committee offering solutions to fix the flawed implementation of the No Surprises Act
• deployed a federal grassroots campaign urging for Medicare Physician Payment reform
• distributed 13 member alerts
• created 6 new member resources: NSA Health Plan Fact v. Fiction, What IDREs Can and Cannot Do and an OON EM Billing Process Infographic, State Reg & Leg Tracking, Federal Reg & Leg Tracking, ACT page
• Released 2 member-supported studies
• Wins-To-Date:
  • Delay in the split/share in the Medicare Physician Fee Schedule proposed rule
  • Delay in the markup of the HELP Primary Care Legislation that promoted the flawed, non-market based QPA
  • Supported 100+ signers on the Medicare Payment Reform Letter

In 2022, EDPMA:

• held forty-eight meetings with members of Congress
• sent nineteen letters to CMS/CCIIO bringing attention to and recommending solutions for the unlawful and detrimental implementation of the No Surprises Act
• sent twelve letters to Congress on issues ranging for the prevention of proposed Medicare Physician Fee Schedule cuts to supporting the Telehealth Extension Act
• sent eight letters to State Regulators addressing down coding, balance billing and ED leveling policies
• launched two Grassroots Campaigns to revise the Medicare Physician Fee Schedule and to prevent deep Medicare cuts
• EDPMA also filed two Amicus Briefs successfully supporting litigation led by the Texas Medical Association.

These are just a few examples of EDPMA’s 2022 advocacy successes. To learn more about all of EDPMA’s 2022 advocacy successes and previous successes click here.

Need to connect with your elected officials? You can find their contact information here.

For questions regarding our advocacy efforts, contact us at [email protected]

Snapshots of Success

• EDPMA was formed when Medicare Administrative Contractors (MACs) would not allow physicians to reassign their payment to physician groups because the physicians were not “employees” of the group.  EDPMA led the charge to change this policy — lobbying CMS, the Office of Inspector General, and Congress, and asking ACEP, AMA and others to join the fight.  Legislation was passed in 2003 which reversed this practice.  EDPMA continued to work closely with CMS to ensure that the implementing regulations and guidance work for physician groups, billing and coding companies, and our partners.
• EDPMA was a leader in promoting physician participation in testing quality measures reporting mechanisms.   Emergency medicine had more early adopters of the Patient Quality Reporting Initiative (PQRI) than any other specialty.  CMS now recognizes EDPMA as an important and credible partner as it continues to develop new ways to tie reimbursement to quality.
• For over a decade, EDPMA has successfully urged CMS to address delays in 855 application processing times and to improve enrollment procedures.  EDPMA regularly meets with CMS officials on these matters.
• EDPMA helped stop state efforts to deny coverage to Medicaid patients receiving care in the emergency room who were protected by the prudent layperson standard.
• EDPMA led the fight to protect the physicians’ right to continue to use the 1995 Medicare Documentation Guidelines for evaluation and management visits as an alternative to the 1997 Documentation Guidelines.  This important success makes it significantly easier to document care.
• EDPMA joined with its coalition partners, such as ACEP and others, to prevent Washington State from limiting the number of emergency room visits covered by Medicaid.

EDPMA advocates on many topics impacting emergency department practices. Click here to view our advocacy letters. You must be a member to view these materials.