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Access to Emergency Medical Services Act

March 24, 2009:

The House and Senate recently announced the formation of the United States Bipartisan Commission on Access to Emergency Medical Services. This commission was formed to identify and examine factors that affect delivery of screening and stabilization services in hospitals with emergency departments.

This commission also will make specific recommendations to Congress regarding federal programs, policies, and financing that may be needed to ensure the availability of these services in conjunction with state, local, and federal programs for responding to disasters and emergencies.

The commission will comprise 24 members—eight appointed by the President, eight appointed by the House, and eight appointed by the Senate. Each group of eight will be split into four groups of two representing the following:

  • Emergency physicians, nurses and other health care professionals who provide emergency medical services.
  • Elected or appointed local, state, or federal officials who are involved in issues and programs related to emergency medical services.
  • Health care consumer advocates
  • Hospitals and health systems that provide emergency medical services

The legislation will help to limit or reduce dangerous patterns that hinder the public’s ability to receive high-quality, lifesaving medical care. Furthermore, the bill recognizes the need for additional resources supporting care delivery. In particular, this bill calls for CMS to collect data on emergency department “boarding” in order to establish standards and guidelines where appropriate. Patient boarding is a result of staff shortages and limited hospital beds. Admission of patients through the emergency department contributes to overcrowding and places lives at risk.

The American College of Emergency Physicians released a national report card on the state of emergency medicine in December 2008 that gave the nation a near-failing D- grade in the category of access to emergency care. More than a dozen states received failing grades in this category. In 2006, the Institute of Medicine (IOM) found the nation’s emergency medical system overburdened, underfunded and highly fragmented. The Centers for Disease Control states that the annual number of ED visits increased 32 percent, from 90.3 million up to 119.2 million between 1996 and 2006 while emergency departments decreased by approximately 9 percent, thus leaving fewer EDs to serve more patients.

A 10 percent increase in physician payments for services related to the Emergency Medical Treatment and Active Labor Act and provided to Medicare beneficiaries in EDs proposed in the legislation would help offset the enormous financial burden placed on emergency physicians who currently provide an average of almost $140,000 in uncompensated EMTALA-related care each year. Shortages of on-call specialists would be alleviated by additional funding for all physicians who provide care in EDs.

Furthermore, the legislation provides that CMS will convene a working group to include experts in emergency care, inpatient critical care, hospital operations management, nursing, and other relevant disciplines. The administrator of CMS will appoint members, and their duties will include:

  • Development of standards, guidelines, measures and incentives
  • Identification of barriers
  • Identification of best practices
  • Other legislative and administrative actions as the group deems appropriate

More information on the Access to Emergency Medical Services Act of 2009 is on the American College of Emergency Physicians website at: www.acep.org.

Karen M Prescott, CMM, CPC, CPC-I, CCS-P, PCS
Clinical/Technical Editor


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