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 and its members share a commitment to improve emergency healthcare for all Oregonians.
OCEP membership has risen to over 500 emergency physicians in every part of the state.
The OCEP Board has strong leadership and Liz Mesberg, the long-time stellar Chapter Exec. Katy King has been Government Relations Director and lobbyist since 2013.
Dr. John Moorhead is a member! He joined the Department of Emergency Medicine in 1978 and is a pioneer in emergency medicine 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.
Dr. Moorhead also represented OCEP in the creation of the Oregon Trauma System. OCEP member Dr. Ron Potts represented Kaiser. Kaiser’s support was instrumental in getting the plan finalized.
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, Jeff Disney, Mo Dana, Mary Tanski and others.
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.
The Emergency Medical Treatment and Labor Act (EMTALA) formally established by Congress in 1986 is a hallmark of emergency medicine, establishing the unfunded mandate requiring everyone presenting to an emergency department receive a medical screening examination, regardless of their ability to pay for the services provided to them. This federal law set the standard for emergency medicine care being available to all patients 24/7/365. Emergency medicine today provides the highest incidence of EMTALA mandated care among all medical specialties.
Emergency physicians and their departments are the safety net of our healthcare system. They are available 24/7/365 to everyone, regardless of their ability to pay.
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 the medical condition. This bill removed the sunset on statutes that make 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. The statute employs a “prudent lay person” standard, meaning that an insurer may not deny claims for emergency medical care as long as the insured was reasonable in seeking out or initiating emergency treatment. The original legislation (1997) contained a sunset provision, which was extended during the 2003 legislative session. The measure is the result of an agreement developed by insurers and medical providers.
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.
OCEP supports evidence-based, coordinated pain treatment guidelines that promote adequate pain control, health care access and flexibility for physician judgment. OCEP, in coordination with ACEP, the Washington chapter of ACEP and national partners such as the AMA, CDC, FDA and others, has been educating its members and the public on safe prescribing guidelines for a number of years and the efforts have already shown great success.
The chapter has also been active partners in supporting and implementing the Emergency Department Information Exchange, supporting legislation to improve the Prescription Drug Monitoring Program and naloxone prescriptions, serving on opioid task forces at the state and national level and prioritizing appropriate patient care.
Emergency Healthcare Task Force. OCEP decides to tackle issues contained in ACEP’s 2009 National Report Card on the State of Emergency Medicine. A letter from the chapter gets the attention of the governor and the OHA Director. John Moorhead is appointed to chair a 2010 Task Force to make recommendations to reform the system. SB 234 (2011) doesn’t pass but OCEP doesn’t give up.
OCEP supports SB 355, which establishes the Prescription Drug Monitoring Program.
The chapter strongly supported bills in 2009 to require safety belts and helmets for kids riding ATVs. These bills passed. They opposed bills to remove the helmet requirement for motorcycles and the bill failed. A new bill in 2011 failed then too.
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.
The Governor signs a medical amnesty bill supported by OCEP, which grants limited immunity for underage drinkers seeking medical attention for alcohol poisoning. 2014.
OCEP blocks a bill (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.
The chapter also opposed SB 186 in 2015, which would have permitted public dispensing machines for epinephrine; and SB 409, a bill promoted by the trial lawyers to repeal the $500,000 statutory cap on damages recoverable in wrongful death actions. Both bills failed.
OCEP strongly supports bills to prevent violence against health care workers and to increase penalties for HCW assault in 2015, 2017, 2021 and 2022.
OCEP is part of a stakeholder group to pursue safe labeling and dosing practices for marijuana edibles.
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.
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.
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.
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.
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.
In 2017, OCEP Board member and emergency physician Dr. Sharon Meieran, is sworn in as Multnomah County Commissioner.
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 supports the Governor’s Opioid Task Force in 2018.
In 2019, OCEP opposes bills to lift the cap on damages that juries can award for pain and suffering, a requirement on hospital emergency departments to become medical detoxification centers. The chapter supports a bill on needle stick injuries, which passes.
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.
Emergency physicians and other healthcare providers are hailed by the public as heroes with nightly applause as the COVID pandemic forces a world-wide shutdown. They continue to show up for work every single day of the crisis which has killed over a million people in the U.S. and nearly 8,000 in Oregon.
OCEP works with the Governor’s Office and multiple local and regional news outlets encouraging safe socialization practices and promoting vaccination for Oregonians.
OCEP works with the Governor’s Office on a Labor Day message encouraging Oregonians to get vaccinated.
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.
Helping people in mental health crises is a priority for OCEP. The chapter supports investments in workforce, access, parity, and telehealth.
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.
EM workforce. OCEP supports steps to fill gaps in emergency care in rural and underserved communities .
Federal advocacy. OCEP works closely with Oregon’s Congressional Delegation on federal emergency medicine priorities set by ACEP.
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.
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.
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.
OCEP brings together the emergency medicine community for decades to exchange ideas and reconnect through its annual conference.
OCEP enhances the continuing education of the emergency medicine community with thousands of lectures and continuing education activities over several decades at the annual conference.
OCEP supports medical students and other learners with educational and networking activities connecting them to the legacy of emergency medicine excellence in the state.
OCEP lobbies for safe, effective and easy access to Naloxone for Oregonians while protecting providers from additional prescribing requirements and red tape that don’t translate to improved patient outcomes.
OCEP brings physicians together!Oregon has one of the longest running annual education meetings of any state chapter and offers excellent speakers (including celebrity physician Dr. Glaucomflecken) and hosted a cadaver lab. The food and networking is stellar and this is one of the only CME conferences with beer!
