Fifty+ years of leadership! OR-ACEP, also known as the Oregon College of Emergency Physicians, is a medical society that has represented physicians specializing in Emergency Medicine since 1971. Its members share a commitment to improve emergency healthcare for all Oregonians. OCEP also works closely with Oregon’s Congressional Delegation on federal emergency medicine priorities set by ACEP. Membership has risen to over 500 emergency physicians in every part of the state.
Dr. John Moorhead joined the OHSU Department of Emergency Medicine in 1978 and is a pioneer in EM training and advocacy. He’s the former President of the American Board of Emergency Medicine, the American College of Emergency Physicians, and the Oregon Medical Association. He also represented OCEP in the creation of the Oregon Trauma System.
OCEP member Dr. Ron Potts also represented Kaiser, an organization whose support was instrumental in getting the Oregon Trauma System plan finalized.
OCEP member Craig Newgard has been instrumental with ongoing research proving better outcomes after system implementation for the general population and for specific sub-populations, including minorities.
In 2017, OCEP Board member and emergency physician Dr. Sharon Meieran, is sworn in as Multnomah County Commissioner.
OCEP members are active in national organizations, including ABEM and raise the visibility of our state. Dr. Moorhead and Dr. Hal Thomas have served as President of ABEM. Dr. John Ma has served on the board. Many OCEP members served as examiners including Drs. Thomas, Moorhead, Ma, Disney, Daya, Tanski, and others.
A Long History of Advocacy
OCEP strongly supports bills to prevent violence against health care workers and to increase penalties for HCW assault in 2015, 2017, 2021 and 2022.
In 2019, OCEP opposes bills to lift the cap on damages that juries can award for pain and suffering, and a requirement on hospital emergency departments to become medical detoxification centers. The chapter supports a bill on needle stick injuries, which passes.
The chapter opposed SB 409, a bill promoted by the trial lawyers to repeal the $500,000 statutory cap on damages recoverable in wrongful death actions – the bill failed.
In 2022, OCEP teamed up with the Oregon Emergency Nurses Association, OMA and other partners on a bill to prevent violence against healthcare workers. For the first time, it passes the House 53-7 but dies in the Senate during the end of session. A bill to establish a community violence intervention program in hospitals, passes.
Insurance and Billing
Passage of the Prudent Layperson Standard in 1997 and 2005. OCEP supported House Bill 3465 relating to continuation of health insurance coverage for medical condition for which a prudent layperson believes immediate medical attention is necessary to stabilize their medical condition. Resultantly makes it illegal for providers of commercial health insurance to deny a claim or require preauthorization for emergency medical screening exams and procedures required to stabilize an emergency medical condition.
In 2018, HB 2339, which bans out-of-network balance billing for emergency providers passed. OCEP blocked a version of this bill which tied provider reimbursement to a percentage of Medicare and the unenforceable Greater of Three rule, which was then subject to a legal challenge by ACEP.
In 2016, OCEP began advocacy for fair reimbursement and preservation of the safety net during stakeholder meetings on a DCBS bill to ban out-of-network balance billing.
OCEP worked with DCBS and legislators to negotiate compromise amendments, which require a workgroup to develop recommendations in time for the 2018 session. OCEP (Past) President-Elect Chris Strear serves on the committee and leads efforts for fair reimbursement.
In 2018, a compromise solution on balance billing was achieved in advance of March 1, 2018 ban. Without legislative action, it looked like providers would have to negotiate OON claims on a case-by-case basis, work it out or go to court. This would give insurers enormous leverage at the contracting table with some insurers using the law as a mechanism to set or reduce in-network as well as OON rates, forcing providers to accept below-market rates for services and jeopardizing the patient safety net. An interim rate was put in place with a 2022 sunset.
OCEP fights back against downcoding practices. In Oregon, a major payer adopted policies to reimburse based on final diagnosis, not presenting symptoms. This is a violation of the prudent layperson act. OCEP asked DCBS to issue guidance prohibiting this practice. When it was determined it was not in their purview, the chapter sought assistance from ACEP and NEMPAC to demand the insurer cease this policy.
HB 2042 fails to advance in a big win for emergency physicians. Reimbursement will default to the methodology in the federal “No Surprises Act,” which includes an independent dispute resolution process. OCEP strongly advocated for this outcome. EMTALA requirements and the state ban on balance billing have uniquely disadvantaged emergency medicine. OR-ACEP emergency medicine groups have reported reductions in contracts between 8 percent and 47 percent since March of 2018. This bill will level the playing field in contract negotiations and help to preserve the patient safety net, especially in rural areas.
OCEP was one of the first organizations to address the opioid crisis in Oregon, spearheading the development of consistent opioid prescribing guidelines for emergency physicians across the state nearly ten years ago. The chapter also served on OHA workgroups in 2016 and 2018 to develop guidelines for chronic and acute care prescribing that were informed, in part, by OR-ACEP prescribing guidelines.
In 2014, the Governor signs a medical amnesty bill supported by OCEP, which grants limited immunity for underage drinkers seeking medical attention for alcohol poisoning.
OCEP is part of a stakeholder group to pursue safe labeling and dosing practices for marijuana edibles.
HB 2114, an opioid guideline bill passed. OCEP opposed a version of this bill which would limit Rx to 7 days and impose criminal penalties on providers.
OCEP supports the Governor’s Opioid Task Force in 2018.
The chapter has been an active partner in supporting and implementing the Emergency Department Information Exchange, supporting legislation to improve the Prescription Drug Monitoring Program SB 355 and naloxone prescriptions, serving on opioid task forces at the state and national level, and prioritizing appropriate patient care.
The chapter strongly supported bills in 2009 to require safety belts and helmets for kids riding ATVs. They opposed bills to remove the helmet requirement for motorcycles.
The Oregon Patient Safety Commission, supported by OCEP, is established. The Governor signed the legislation March 17, 2009.
OCEP supports SB 95, which created the Medical Liability Task Force in 2010.
OCEP blocks SB 835 2015 which would have required hospital emergency departments to refer for primary care a person who presents at an ED but does not have a condition requiring emergency medical services. The chapter this bill as an EMTALA violation and a violation of the prudent layperson standard.
SB 817 which allows urgent care facilities to advertise emergency services, failed. OCEP and other providers blocked this bill from ZoomCare, which would allow urgent care facilities to advertise emergency services.
OCEP advocated for CAWEM coverage for End Stage Renal Disease (ERSD) dialysis patients: Funding in the OHA budget bill will provide life-saving scheduled dialysis treatment for undocumented patients who otherwise must wait until their condition lands them in the ED. This coverage, combined with Cover All People (HB 3352 and also supported by OCEP,) will help provide access to critical health services for Oregon’s uninsured population.
Helping people in mental health crises is a priority for OCEP. The chapter supports investments in workforce, access, parity, and telehealth.
Safe storage for guns: OR-ACEP supported SB 554, a landmark bill in 2021 to keep guns out of the hands of kids and to prevent unintentional injury and death.
OCEP endorses Measure 114, the Gun Violence Reduction Act.
At the onset of the COVID-19 pandemic, OCEP worked urgently with the Governor and her staff, Oregon’s Congressional delegation, state legislative leadership, OHA, and the media to advocate for fair distribution of PPE and transparency during the PPE shortage crisis. As a result of a hearing in the House Health Care Committee requested by OCEP, OHA convened a workgroup to improve transparency of supplies and establish PPE safety committees at each hospital.
OCEP works with the Governor’s Office and multiple local and regional news outlets encouraging safe socialization practices and promoting Labor Day and other messages encouraging Oregonians to get vaccinated.