EDPMA advocates for the practice of emergency medicine through federal, regulatory and state advocacy.
Priority issues include implementation of the No Surprises Act, fixing the Medicare physician fee schedule, protecting EMTALA and keeping patients out of the middle of payment disputes.
Join Us For EDPMA Lobby Day in Washington DC!
We are excited to invite our members to participate in our 2024 EDPMA Lobby Day, where your voice can make a real impact on issues that matter most to our industry. We partner new advocates with seasoned advocates and a Hart Health Strategies partner to guide your day. This is a unique opportunity for you to engage with policymakers, share your perspectives, and advocate for policies that support our collective goals.
Tuesday, May 21 – Travel to DC
EDPMA-PAC Reception honoring Rep. Greg Murphy, MD (R-NC-03)
The Westin Washington DC Downtown
999 9th Street NW
Wednesday, May 22 – 7am – 4:30p Lobby Day
Breakfast at The Westin Washington DC Downtown (999 9th Street NW) for group huddles followed by Hill visits
5:00p Optional Lobby Day Debrief
Evening Departures (or on May 23)
What to Expect:
- Advocacy Training: Before meeting with policymakers, we will provide a virtual training session to equip you with the necessary tools and information to effectively communicate your message. On Lobby Day, we offer a refresher on our issues and group you with other advocates from your state.
- Policy Briefings: Stay informed with briefings on key issues that our association is actively working on. Understand the background, current status, and potential impact of these issues.
- Meetings with Legislators: You will have the opportunity to meet with legislators and their staff to discuss the issues that matter most to our industry. Share your experiences, insights, and perspectives to help shape better policies.
- Networking Opportunities: Connect with fellow EDPMA members to build valuable relationships and alliances that can strengthen our collective advocacy efforts.
- Q&A Sessions: Engage in interactive Q&A sessions with experts and policymakers to get a deeper understanding of the legislative process and the impact of policies on our industry.
- Influence Policy: Your participation can directly impact policy decisions that affect our industry. Legislators value the input of engaged and informed constituents.
- Networking: Connect with like-minded professionals and build a strong network within our industry. Lobby Day provides a unique platform for collaboration and relationship-building.
- Learn from Experts: Gain insights from experts in the field during training sessions and policy briefings. Stay updated on the latest developments that may impact your business or profession.
- Be a Voice for Change: Lobby Day empowers you to be an advocate for positive change. Your voice matters, and this is your chance to contribute to the betterment of our industry.
For any questions or more information, contact Cathey Wise.
We look forward to seeing you at Association Lobby Day!
EDPMA’s 2024 federal legislative priorities include:
Reforming the Medicare Physician Fee Schedule by:
- fully offsetting the 3.4% reduction planned for 2024
- providing an annual inflationary update, and
- modernizing the budget neutrality requirement.
- pushing for long-term reform
Continued pressure for the fair implementation and enforcement of the No Surprises Act
- Improving enforcement mechanisms that protect patients and ensure smooth implementation of the law by:
- Creating penalties for payers who fail to meet the statutory payment deadline of 30 days following a determination made by the independent dispute resolution (IDR)entity.
- Creating penalties for statutory violations of patient protections by payers that mirror the penalties for similar violations by providers.
- Providing additional transparency requirements.
Eliminate third-party fees for provider reimbursement (EFT and Virtual Credit Card fees)
Improve network adequacy standards including:
- Standby costs
- National emergency
- Commercial Tax
AI and Medical Decision Making
EDPMA Data Analysis: No Surprises Act Independent Dispute Resolutions – Deficiencies and Compliance Failures
EDPMA surveyed its membership to report on issues related to the implementation of the No Surprises Act (NSA) and its Independent Dispute Resolution (IDR) process since its enactment on January 1, 2022. This data documents our members’ experiences with the IDR process and represents a high-level summary of initial findings and represents at least one-fourth of all emergency department (ED) visits in the United States and prior to the August 3, 2023, closing of the federal IDR portal. See the full report here.
EDPMA’s study reveals:
- 91% of filed claims remain open and unadjudicated.
- 95.6% of outstanding claims are 5+ old from 127 health plans.
- 46% of the time, payers are not responding during the 30-day Open Negotiation period.
- 52% of the time, payers do not acknowledge an IDR had been filed.
- 75% of payers who actually respond in the IDR process do not make an actionable offer.
- 60% of payers are not updating the QPA amounts with the statutorily required inflationary update.
- Payers are not participating in a 30-day open negotiation period and IDR process as expected by statute.
- Rapid and effective enforcement is not happening.
- 87% of payers did not pay in accordance with the IDR Entity decision.
EDPMA offers these solutions:
- Implement the law as designed.
- Congressional involvement
- Rapid and effective enforcement
- EMTALA must now be funded.
EDPMA Data Analysis: Qualifying Payment Amounts and Health Plan Compliance Under the No Surprises Act
EDPMA surveyed its membership to report on issues related to the implementation of the No Surprises Act (NSA) since January 1, 2022.
See the study findings here.
EDPMA’s study reveals:
- 91% of claims surveyed did comply with the NSA’s statutory and regulatory QPA disclosure requirements.
- Post-NSA Out-of-Network Payments decreased 92% of the time, compared to Pre-NSA. The average decrease is 32% per ER Visit.
- The Independent Dispute Resolution volumes are driven by artificially low QPAs, payer intransigence, failure of Open Negotiation, health plan termination of in-network agreements, and CMS’ refusal to implement common sense recommendations.
- When reported, the QPA consistently equals the allowed amount for provider payments.
- Emergency Department staffing is in jeopardy.
EDPMA also offers solutions including:
- Congressional Involvement
- Rapid and effective enforcement
- Accurate QPAs
- Require and Clarify RARC Codes
- EMTALA Must Now Be Funded
See our solutions here.
EDPMA Advocacy Primer
If you need help identifying your congressional delegation, finding contact information, or preparing for a meeting, please review the EDPMA Advocacy Primer.
For access to key letters to and from federal and state decision makers and payers, lobby packets, and other helpful information, please visit the toolboxes under the “Resources Tab.”