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2011

Oct 2011:  ACEP Honors 2011 Leadership and Excellence.  Debra G. Perina, MD, FACEP receives award for Outstanding Contribution in EMS.
This award is presented to a member or nonmember who has made a contribution to emergency medical services that is nationally significant in application or scope.
Dr. Perina is an associate professor in the Dept of Emergency Medicine at the University of Virginia School of Medicine (UVA), EMS Fellowship Director, and Division Director of Prehospital Care. She is also a Regional Quality Medical Director for the University of Virginia Health Sciences System.
Since 1985, Dr. Perina has served as an emergency medical services medical director for rural volunteer, metropolitan county services, and air medical services in South Carolina and Virginia. She has published more than 20 chapters and articles on EMS-related issues and is coauthor of the National Highway Traffic Safety Administration's National Standard Medical Director's Curriculum.
She has served on several collaborative committees between ACEP, the American Board of Emergency Medicine, and the National Association of EMS Physicians exploring physician certification in EMS, and is now leading the effort to create the first EMS certification excamination with the American Board of Medical Specialties.

Aug 9, 2011:  Ending the PEND Program. VACEP President Dr. Tamera Barnes, VACEP President Elect Jason Garrison, Dr. James Dudley, VACEP Exec. Director Gwen Harry and VACEP lobbyist Aimee Perron Seibert met with Deputy Secretary of Health Keith Hare and DMAS staff to discuss the elimination of the PEND program. We had met previously with Secretary Hazel who had expressed understanding of the program and it’s detrimental impact on emergency physicians in the Commonwealth. While we understand that the economic situation in Virginia is better than many other states, we also know that as we begin to implement health care reform, it will become more critical for emergency medicine physicians to be on the equal playing field as all other specialties in the realm of reimbursement.
They were very attentive and interested in hearing the history of the PEND program, especially how it had originally started under the misguided auspices that by underpaying physicians, Virginia could reduce Medicaid patients’ visits to the emergency department.  Soon after PEND was implemented, the Federal EMTALA law was passed, barring ED’s from turning away any patients.  Subsequently, the PEND program should have been terminated, but instead, it has slowly been whittled down by the hard work of VACEP to only apply to level 3’s, albeit half the cases you see in the ED. 
DMAS was tasked with looking at the newest numbers to get a handle on the exact cost of full elimination of the program for both physicians and hospitals.  We will keep you informed as the Commonwealth’s budget is being drafted on where we stand with PEND. 

July 11-12, 2011 Hampton Roads Legislative Road Trip
Otherwise dubbed as the ‘Summer of Love’ tour, five of the specialty physician lobbyists, including our own Aimee Perron Seibert, and MSV hopped in a mini van and made a two day trip down to visit as many physician friendly legislators as we could schedule in two days to thank them for their support of our issues. 
The trip began with a brand new delegate, Gordon Helsel of Poquoson, who was elected in the spring to take the retiring Tom Gear’s seat.  Helsel was assigned to House Health, Welfare and Institutions so we took this opportunity to introduce ourselves and our issues to him over an early breakfast in his district. 
Then we set off to see Senator Lucas in Portsmouth, a long time friend to physicians, Delegate Spruill in Chesapeake and Delegate Algie Howell in Norfolk.  Next, we were able to talk with Delegate Sal Iaquinto, the new chair of House Courts- Civil Subcommittee, where all medical malpractice bills went through last year and will go through in the future (hint: potential EMTALA med mal protection).  Joining him was Delegate Ron Villanueva, a delegate entering his second term and interested in learning more about the issues physician’s face in the marketplace. 
We then had the pleasure of having dinner with Senator Ralph Northam and his aide, Matt Strickler. As always, he was up to date on the issues facing physicians and it was a nice opportunity to thank him for all he’s done for doctors in the Senate. 
Finally, on the way back to Richmond, we stopped in Petersburg to have lunch with Delegate Dance, an integral member of the House Appropriations committee who is also the co-chair of the Allied Health Caucus during the legislative session. 
Thanks to everyone who gives to EMPAC- it’s your donations that allow us to continue to build strong relationships with delegates and senators and more importantly, thank them for all they do for physicians.  A simple thank you goes a long way with our elected officials. It’s not something they hear very much!

June 29, 2011:  James Dudley, MD, FACEP and Gwen Harry, VACEP Executive Director met with VDH, skilled/nursing home facility and other stakeholders about problems for readmission to a referring facility following a hospitalization or emergency department visit that crosses over the "midnight" rule.

June 11, 2011:  2011 VHAC/Mission:Lifeline Stakeholder's Summit, Chesterfield, VA.   Hear the latest on the Virginia Heart Attack Coalition/Mission Lifeline STEMI initiative. 

May 3-4, 2011:  Del. Chris Stolle (R-Virginia Beach) and State Health Commissioner Karen Remley received VACEP's first Heroes in Emergency Medicine awards at The EM Summit on May 3 – May 4. 
Stolle introduced and secured passage of HB 1690. This bill provides penalties, including a minimum two days in jail, for anyone who assaults emergency department workers. The law becomes effective July 1.  
Remley demonstrated significant leadership in the development and adoption of guidelines to help hospitals better manage emergency patients when inpatient beds are not available.
"Del. Stolle recognized the harsh realities we sometimes face in emergency medicine by sponsoring legislation that makes violence against us and our staffers a Class I misdemeanor,” said Dr. Tamera Barnes, president of the Virginia College of Emergency Physicians. “As someone who has seen violence in the emergency department, I can tell you firsthand that Del. Stolle’s legislation is good for Virginia’s emergency patients and workers.”
"Commissioner Remley led Virginia in taking a critically important step toward addressing emergency department crowding,” said Barnes. “The guidelines that Commissioner Remley helped develop can reduce emergency department wait times and help cut hospitals costs. My colleagues across the state tell me these guidelines have already helped address these important issues.”

Apr 15, 2011:  Five make the ‘Emergency Medicine Excellence Hospitals’ List.  We thought you might be interested in the attached study, including the listing of the 268 “emergency medicine excellence hospitals” by state, based on HealthGrades' criteria of risk-adjusted mortality outcomes for Medicare patients admitted through the emergency department.
Congratulations to our colleagues at:
Martha Jefferson Hospital, Charlottesville
Augusta Health, Fishersville
Rockingham Memorial Hospital, Harrisonburg
Bon Secours Memorial Regional Medical Center, Mechanicsville
Bon Secours St. Mary's Hospital, Richmond

Mar 18, 2011:  Emergency Health Care Violence Bill HB1690 Enacted. VACEP was represented at the bill signing by Tamera C. Barnes, President and Aimee Perron Siebert, Legislative Consultant. 
Click here for the final version of the bill.  

Feb 28, 2011: Sunday marked the last day of session, or “Sine Die,” finishing just one day late. Over the last six weeks, we’ve had many significant victories! Read all about these in Aimee's blog "The Capitol Connection" here.

Feb 22, 2011:   WUSA interviewed Pete Paganussi, VACEP board member and immediate past president, for a story on Virginia's recently passed legislation to protect emergency department workers from violence.  View it here.

Feb 17, 2011: VACEP joins in request for Governor McDonnel to support the measures to stabilize Virginia’s medical malpractice cap for the next 20 years, HB 1459 and SB 771, along with legislation that protects peer review and quality assurance documents from discovery in litigation proceedings, HB 2373 and SB 1469. Read letter here.

Feb 18, 2011. Del Stolle HB 1690 passes the Senate. It will now go to the Governor for signature! Read AP news story prominently citing VACEP President Tamera Barnes, picked up by the HR Pilot.

Jan 31, 2011: Advance copies of CMS Revised Anesthesia Services Interpretive Guidelines

Jan 27, 2011: VACEP Election Results. Meet VACEP leaders whose terms begin in February.

Jan 25, 2011: VACEP Members Support White Coats on Call at the General Assembly. Report and photes.

2010

Dec 21, 2010: Governor McDonnell Receives Final Report and Recommendations from the Virginia Health Reform Initiative Advisory Council. Click here.

Dec 15, 2010:  In VACEP’s continued push to eliminate the unfair and antiquated DMAS PEND program, VaCEP's President Tamera Barnes, Executive Director Gwen Harry and lobbyist Aimee Perron Seibert met last week with the new DMAS director, Dr. Gregg Pane. Not only is Dr. Pane a physician, but he is a trained emergency physician. He was quick to grasp the issue, as well as understanding that he is our best hope to eliminate the program. We will continue to work with him to finally get rid of PEND.

Dec 13, 2010:  Today Judge Hudson issued his decision in Attorney General Cuccinelli's lawsuit challenging the ACA's minimum responsibility requirement ("individual mandate").  The Judge found the mandate is unconstitutional (beyond the scope of Congressional authority under the Commerce Clause), but he did not rule on or stop any other aspect of the ACA (decision attached).  On the other hand, two other District Court judges, including Judge Moon in Lynchburg, found the provision is constitutional.  So there's still a long way to go before a final decision is issued on this question.

Dec 13, 2010: New Adjustments/MEI - The Medicare Economic Index (MEI) is used in conjunction with the SGR formula to update the physician fee schedule.  For 2011, CMS will “rebase” the MEI, i.e. update the base year to from 2000 to 2006 (the most recent year with complete information) to reflect changes in prices of goods and services physicians purchase to run their practices.  Further, some of the components or categories that comprise the MEI were revised. 

o    The impact of the proposed MEI changes varies by specialty.  Data from the PCPI survey (that ACEP supported and participated in) showed that practice expense (PE) and medical liability costs grew at a faster rate than physician “work”.  Therefore, CMS increased the PE RVUs used in the MEI to 47.44%, malpractice RVUs from 3 to 4%, and reduced work from 52.46% to 48.27% of total RVUs. 

o    Because these changes must be budget neutral in overall impact, CMS made the reduction to the Conversion Factor rather than reduce Work values.  Therefore, the proposed payment levels for high practice expense specialties will increase, while payment to low practice expense specialties, such as emergency medicine may decrease slightly.

o    CMS will also appoint a Technical Advisory Panel to review MEI components and recommend changes for future rulemaking proposals.

Oct 3, 2010:  The Virginia Pilot reports on how hospitals are changing the ER with comments from VaCEP Past President Carl Wentzel, MD, FACEP.  Click here for complete article.

Sep 15, 2010:  Governor Bob McDonnell announced the members of the six taskforces working in coordination with the Virginia Health Reform Initiative Advisory Council (VHRI).  VaCEP member James Dudley, MD, FACEP appointed to the Service Delivery and Payment Reform Taskforce. 

Sep 15, 2010:  Welcome to New Board Member - Patrick McHugh, DO, FACEP.  Dr. McHugh was voted to fulfill the recently vacated seat of Andrew Garvie, MD, FACEP.  

EMTALA - Fredericksburg Newspaper columnist writes about EMTALA in his blog with comments from our own Dr. Tamera Barnes, FACEP.  The ER as ‘unfunded mandate’ - Rapid Assessment

VACEP works with VDH and VHHA in development of new guideline for boarding of patients.  VACEP President, Dr. Tamera Barnes, FACEP meets with State Health Commissioner Karen Remley, MD, MBA in making announcement at press conference.  You can listen to the entire press conference by calling 800-642-1687; the passcode is 97402249. View Richmond Channel 6 News and Channel 12 Reports in which Dr. Barnes was interviewed about the issue. VACEP Statewide Media Coverage Regarding New VDH Boarding Document

Virginia Health Reform Initiative Advisory Council established.  This Council will provide recommendations to the Governor towards a comprehensive strategy for implementing health reform in Virginia.  The Advisory Council will go beyond federal health reform and recommend other innovative healthcare solutions that meet the needs of Virginia's citizens and government. News release announcing the members of the six taskforces.
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