Surprise Balance Billing
Emergency physicians believe that all Pennsylvanians should be able to use the closest and most appropriate emergency department when they have an acute need; that patients should receive fair insurance coverage and be kept out of disputes regarding payment of balance bills; and that the emergent episode of care is unique, as no one can predict where or when they might require emergency care.
Read the Current Pennsylvania Legislation:
Read SB 678
Read HB 1553
Read PACEP's Resources:
PACEP Balance Billing Talking Points
PACEP FAIR Health Database FAQs (compiled in conjunction with FAIR Health)
Read PACEP's Pennsylvania Emergency Physician Feedback Letter on Senate Bill 678
Article: A Solution to Surprise Medical Billing - When emergency physicians are caught between take-it-or-leave-it contracts and the EMTALA mandate.
Psychiatric Bed and Detoxification Bed Registry - HB 858 & SB 1176
The PA House of Representatives Committee voted out House Bill 825 (the “Bed Registry Act”).
PACEP provided HB 825 sponsoring legislators with suggestions for making the proposed database as useful and valuable for emergency physicians as possible. Prime sponsor Rep. Doyle Heffley (R – Carbon County) reported after the meeting that he will continue to work with PACEP to improve the bill.
E-Prescribing - HB 353
PACEP is working with HB 353 (regarding the electronic prescription of Schedule II controlled substances) sponsoring legislators to ensure that emergency situations be taken into account in e-prescribing regulations.
A warm handoff protocol, developed in partnership by the Pennsylvania departments of Health and Drug and Alcohol Programs as well and the Pennsylvania College of Emergency Physicians, was unveiled Feb. 14 and has been distributed statewide for recommended use by emergency room physicians and other healthcare professionals caring for overdose patients. View the pathway
Other Legislative Items Being Tracked
- HB 713/SB 391 - 302 for substance use disorders - PACEP opposes
- HB 1013 EMS Reimbursement for Non-Transport Services - PACEP supports
- HB 646: Assault of Healthcare Practitioner - PACEP supports
- Clear and Convincing - PACEP supports
- POLST legislation update (Rep Cutler/Sen Yaw) - PACEP supports
- 1699 Opioid PDMP Legislation - PACEP Tracking PDMP Impact
Affordable Health Care Act (AHCA)
As part of a collaborative effort to educate and advocate with the PA Congressional delegation on Medicaid expansion and Medicaid financing reform, PACEP signed a group letter asking legislators to vote no to the AHCA.
The current version of the legislation would allow states to apply for waivers to opt out of providing insurance coverage for essential benefits, including emergency care.
Independence Blue Cross (IBC) policy on modifier 25
Read PAMED’s letter of opposition to Daniel J. Hilferty, President and CEO of Independence Blue Cross on the recently announced policy on modifier 25, set to become effective August 1, 2017. This policy denies appropriate payment for evaluation and management (E&M) services when billed with modifier 25 by reducing reimbursement for those services by 50 percent. In addition to several other specialties, PACEP was a co-signatory on the letter.
Help Make A Difference
Please join our grassroots advocacy network, the “PACEP 911 Network.” By growing and developing our PACEP 911 Network, we will have a more effective voice in Harrisburg.