ED bill would address access, funding

Legislation would require hospital emergency department boarding reports and boost Medicare payments to ED physicians.

By David Glendinning, AMNews staff. March 12, 2007.

Washington -- Emergency physicians are taking another crack at pushing legislation they say is vital for tackling a growing access and readiness crisis in the nation's emergency departments.

Rep. Bart Gordon (D, Tenn.) last month introduced the Access to Emergency Medical Services Act of 2007, which is endorsed by the American College of Emergency Physicians. Sen. Debbie Stabenow (D, Mich.) has prepared a Senate companion bill but has not introduced it yet.

The bipartisan legislation seeks to ameliorate some problems identified in a landmark Institute of Medicine report series in June 2006, which characterized EDs as overcrowded, underfunded and unprepared to respond to disasters. Lawmakers introduced similar legislation in the previous Congress, but the bills never received floor consideration in either chamber.

This year's version would require hospitals to report statistics to the Dept. of Health and Human Services on how long they took on average to move patients from the ED to inpatient beds -- giving an indication of how much each hospital engages in patient boarding in the ED. Hospitals would not be allowed to participate in Medicare unless they provided this information, which HHS would make publicly available.

Emergency physicians from Albuquerque, N.M., to Rochester, N.Y., are complaining that excessive boarding by hospitals is making a critical situation even more dire, said Nick Jouriles, MD, an emergency physician in Akron, Ohio, and an ACEP vice president. A hospital that boards a patient in the ED to free up an inpatient bed cuts down on the capacity of the emergency department and imposes an added strain on the physicians who work there.