Newsletters

POSTED: March 12th, 2019
POSTED IN: EM Pulse - The Official Newsletter of MOCEP, January/February 2019,

Greetings all!

While it’s been a cold and snowy last few months, it’s starting to warm up. That means that we are right square in the middle of the legislative session, where things have definitely been heating up! So what is going on you might ask?

Well as usual, there is a lot of talk about opioids and prescribing. Most importantly, I’ve had a lot of questions about where Missouri stands on the PDMP. For those that aren’t aware, the Senator that has killed the bill the last few years has termed out so everyone is feeling more optimistic this year. The PDMP passed the House and is now in the Senate. However, on its first attempt, the bill got stuck in committee. While the President of the Senate is fully supportive, there is still a fair amount of opposition in the Senate, even though that one senator is gone. While PDMPs aren’t a panacea, if used properly, they can be helpful. If it were to pass, this could make it easier for electronic health records to directly access the PDMP data so that providers would not have to sign in each time they wanted to access it. So please make sure to lobby your Senator about why we need an official statewide PDMP. In the meantime, the St. Louis County PDMP is available for everyone and covers approximately 80% of the state’s population and allows for a multi-state search. Feel free to read more about PDMPs here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6312172/. In addition to the PDMP, we are keeping a close eye on several opioid-related bills. While well intentioned, they could cause unnecessary prescribing barriers when a prescription is appropriate.

Our EMTALA bill (SB67) has been second read in the Senate Government Reform Committee. The next step is to have a lawyer testify regarding legal standards addressed by the bill. Afterwards, it will be on to us to teach our legislators about this bill and make them understand why it is so important. In addition to offering us protection while we operate under a federal mandate to care for sick patients that we don’t know, it will also protect our consultants that assist us in the ED. Our hope would be that this would further incentivize consultants to help patients when we ask.

By the time you read this, we’ll also likely have had another successful Advocacy Day on March 5^th.  In addition to participating in MSMA activities, we have reserved a breakout session with MOHealthNet director Todd Richardson, Senator Bill White, and Representative Jon Patterson. One issue that we’ll be discussing with our legislators is the automatic downcoding based on final diagnosis that some insurance companies have enacted. We’ve already discussed this with ACEP and are watching what other states are doing about this. In the meantime if you have information from your department that you can share with us about this, please pass it on.

Lastly, I’d like to remind everyone about our first Leadership Summit and the General Membership Meeting that follows on May 22^nd in St. Louis. The agenda is finalized and we’ll be having speakers discussing topics such as bedside ultrasound management and billing, the geriatric ED, psychiatric patients in the ED, wellness, implementing a medication assisted therapy program, and much more. More importantly, we hope this will serve as an opportunity for ED directors to discuss issues that are important to them and allow us to better continue a statewide dialogue about these issues. For more information and to register, please go to https://mocep.org/2019/01/emergency-medicine-leadership-summit/.

As always, should you have any other questions, concerns, or suggestions, please reach out to me at [email protected] or our executive director at [email protected]

Sincerely,

Evan Schwarz, MD, FACEP, FACMT
President, MOCEP