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Advocacy Committee- Merle Hillman, MD

MNACEP participates in the 2007 ACEP Leadership and Advocacy Conference in DC.
A delegation from MN ACEP attended the 2007 ACEP Leadership and Advocacy Conference in Washington DC from April 29 through May 3, 2007. The group attended ACEP leadership courses, media training workshops and advocacy sessions throughout the week. The group made Capitol Hill visits to both Minnesota senators and eight Minnesota congressional staff seeking support and co-sponsorship of the “Access to Emergency Medical Services Act of 2007”. This proposed legislation (HR 882/S 1003) would create a national, bipartisan commission to examine factors affecting access to emergency services (including medical liability, on-call physician shortages, etc), provide additional payments to physicians (including emergency physicians and on-call specialists) who provide EMTALA related care and calls for CMS to study emergency department boarding and overcrowding.

These face-to-face meetings are critical in gaining support for ACEP-supported legislation as we were able to give the legislators and their staff a first-hand account of the barriers to the delivery of emergency care today. As a result of our visit, Rep. Jim Ramstad has agreed to co-sponsor HR 882. This is especially helpful since Rep. Ramstad is a member of the House Ways and Means Health subcommittee which has jurisdiction over the bill.

Additionally, we were able to dialogue with our legislators and their staff and encourage them to visit our emergency departments when they are in Minnesota. Overall, this was an excellent conference, created a bonding experience between the attendees and gave us an opportunity to meet with, share our concerns and suggest potential solutions to our legislators.

Attendees included Dr. Christian Ball (HCMC EM G-2), Dr. Danielle Hart (HCMC EM G-2), Dr. Joey Charles (Regions EM G-2), Dr. Eric Gross (HCMC), Dr. Brent Asplin (Regions), Dr. Merle Hillman (United), Dr. Bob Grow (Mayo), and Shari Augustin (Executive Director MN ACEP).

Submitted by,

Merle Hillman, MD
President Elect

Legislative Update- O.J. Doyle, Legislative Consultant

January, 2008

Even-numbered years have historically been relatively short, marginally controversial and focused on passing a bonding bill to fund various state building repairs as well as road and bridge upgrades. Legislative leaders try to keep the agendas modest with the hope that partisan controversies are kept to a minimum. Considering the current political climate at the Capitol, ignore everything I wrote in this paragraph.

Periodically, the legislative process hits what may best be termed as ‘critical mass’. That is, the demands of various special interest groups or the public at large, hit a point when responsive legislation becomes an imperative.

On the agenda for 2008 there is a massive health care reform package which seeks to fundamentally change the health insurance industry, expand access, emphasize home care versus in-hospital care when possible; and, reimbursement based on patient outcomes (i.e. preventive care).

Increased funding for the transportation infrastructure, increased gas tax, primary seat belt legislation; and, perhaps restrictions on driving while using cell phones – are all on a number of legislator’s wish lists.

Minnesota ACEP will be heavily involved in an effort to chip away at unlimited liability for ambulance services and ambulance service medical directors by making them state employees for purposes of liability in cases of “disasters” or “mass casualty” incidents. Rather than these entities facing unlimited liability, they would fall under government liability caps of $1,000,000 per incident.

We will also be closely monitoring efforts to repeal the current No Fault Automobile Insurance law. As many of you know, the law carries a mandated minimum $20,000 health benefit coverage. This is a critical revenue source for Emergency Medical Services (EMS). Should No Fault be repealed, the $20,000 benefit would go with it. Currently, we are negotiating for a means of retaining the health benefit regardless of the fate of No Fault.

In 2009, the Statewide Trauma System takes effect. The offices located within the Minnesota Department of Health have a very modest budget and to successfully implement the statewide system, additional resources will be essential.
Last, a significant amount of any lobbyist’s time is spent on the defensive. With the state facing a deficit, there will be little or no money for new programmatic funding. Consequently, new initiatives will be dependent on taking money from existing programs. ACEP-initiated programs such as CALS will be vulnerable and we will need to be particularly vigilant in retaining full funding.

Communications Committee- Christopher Obetz, MD

Our goal is to provide a comprehensive repository of relevant information and resources for current and future MN-ACEP members. We want your voice to be heard, so our website also features the ability to identify and directly contact board members.

MN-ACEP has many objectives, but education and Emergency Physician advocacy stand at the top. Frequent updates on news from the capitol as well as links to ACEP-sponsored educational conferences will be highlighted.

Take some time to browse the site, and contact our board members or our webmaster if you have questions, concerns or suggestions

DMAT- Merle Hillman, MD

MN-1 DMAT

The MN-1 DMAT (Minnesota Disaster Assistance Team) was formed in May 2002 as part of the NDMS (National Disaster Medical System) under the sponsorship of MN ACEP. The MN-1 DMAT is now a level II (operational) DMAT and has deployed extensively during the 2004 Florida hurricanes and in 2005 to New Orleans and the Mississippi gulf coast region. MN-1 DMAT currently consists of 120 members including physicians, nurses, paramedics, EMTs, pharmacists, mental health specialists/chaplains,
respiratory therapists, communications (dispatchers), logistics specialists, administrative specialists and safety/security officers. Although we were not deployed in 2007, we attended the 2007 NDMS conference in Nashville, Tennessee and trained with the OH-1 DMAT in Toledo, Ohio. While we train and attend local meetings as volunteers, we become intermittent federal employees when activated. This allows us to be licensed in all 50 states plus the US protectorates (Puerto Rico, US Virgin Islands and Guam), covers us with federal malpractice insurance and federal workman’s’ compensation while on deployment, gives us USSERA coverage (federal job protection) while on deployment and pays us a salary while on deployment. The majority of our team physicians are emergency medicine specialists including our chief medical officer, Dr. Paul Satterlee. NDMS is currently transitioning from FEMA/DHS back to ASPR/HHS and the process for new applications has not yet re-opened, but hopefully will re-open early in 2008. MN-1 DMAT members will again attend the NDMS Annual Meeting in Nashville, Tennessee in March 2008 and will participate in a regional field training exercise later this spring.

The MN-1 DMAT anticipates playing a key role in medical preparedness and response at the RNC (Republican National Convention) scheduled for September 1-4, 2008 in St. Paul, MN. If you are interested in joining or learning more about the MN-1 DMAT please check out our web site at www.mndmat.com or contact me at merle.Hillman@comcast.net.

Merle Hillman, MD
Team Commander, MN-1 DMAT

Education Committee- Teri Gunnarson, MD

For almost 40 years, ACEP has been the emergency physician's preferred provider of continuing medical education in emergency medicine. You can continue to count on us for the very best in educational meetings, publications, and online CME. We're committed to keeping you up-to-date on the latest developments in the specialty and helping you comply with your CME requirements.

Active ACEP members must earn 150 hours of CME credit every 3 years.
Of these 150 hours, 60 must have been designated as ACEP Category I.
CME requirements for medical licensure vary by state. View a list of CME requirements by state, as compiled by the ACEP Electronic Medical Education Subcommittee.

Reimbursement Committee- Tom Combs, MD

1/08/2008

To: MNACEP Members
Re: MNACEP Reimbursement committee

The MNACEP Reimbursement committee focus is on membership opportunity… Opportunity for sharing knowledge on practice improvement and service expansion... Opportunity for increased and more appropriate reimbursement … Opportunity for effective physician advocacy to payers and powerful regulatory agencies…the opportunity to improve the likelihood of your practice surviving and thriving in an increasingly challenging environment.

Recent and ongoing committee activities include - an outstanding comprehensive presentation and reference on introduction of ED ‘anesthesia service’, documentation/coding ‘critical care’ initiative, multi hospital/group survey of professional service practices, facilitated introduction of ultrasound service, payment refusals activity, legislative and regulatory monitoring, networking with national authorities, comparative coding education, initiation of support for ‘induced hypothermia’ service, valuable coder exchange/education and more. This group provides access to meaningful opportunities for improved ED practice health.

The MNACEP Reimbursement committee represents a tremendous resource for you and your practice. Recent Board of Directors and Reimbursement committee meetings support efforts to increase ease of access for general membership. Efforts to accomplish this goal are ongoing. Please share any suggestions on improving access and/or enhancing our organization’s communication and effectiveness.

We propose, initially, inclusion on the MNACEP web site with facilitated access to our reference articles, reports and initiatives. It is additionally hoped that this effort will increase the communication among our membership and strengthen our ability to respond to reimbursement issues (i.e. deal with ‘payer’ problems and take advantage of new service/procedure opportunities). It is anticipated that our organization should become an increasingly important influence in our state’s medical service and reimbursement environment.

Thank You –

                                                                                    Tom Combs, MD
                                                            Chair - MNACEP Reimbursement Committee
                                                                        tjc4444@earthlink.net