Complete Story


The GSACEP Advocacy Team Needs to Hear YOUR Voice

CDR Christine DeForest, DO

H.R. 776, the James M. Inhofe National Defense Authorization Act (NDAA) for Fiscal Year 2023, showcases two prime examples of how the diligent effort of engaged GSACEP members has caused meaningful changes in how Emergency Medicine physicians work to care for TRICARE beneficiaries and their families.

ACEP works hard to help EM physicians working in the trenches, and while there is overlap between civilian and military facilities, there are also unique aspects to the care delivered in a Military MTF or VA hospital. While the national opioid crisis has received a great deal of attention, we have been tirelessly advocating for ways to improve opioid safety in a military-specific context. LTC Laura Tilley, immediate past president of GSACEP, worked tirelessly, collaborating with other specialists to introduce a MHS Stepped Care Model that reduces opioid use and improves safety when a condition warrants opioid therapy. She was a strong supporter of the Sharing Health Information to Ensure Lifesaving Drug Safety (SHIELDS) Act which was brought out of the House of Representatives in April 2018, co-sponsored by U.S. Rep. Mike Turner, the chair of the House Armed Services Subcommittee on Tactical Air and Land Forces. The SHIELDS Act fed into a section of the Defense Bill in May 2018 attempting to improve accountability of the opioids prescribed to TRICARE beneficiaries. This change increased reporting for TRICARE beneficiaries which had previously been unaccounted for in our statewide reporting programs. A pilot program was then drafted into Section 716 of the 2019 NDAA. This work culminated in Section 719 of the 2023 NDAA, authorizing a permanent program to improve opioid management in the military health system. 

The 2023 NDAA was also notable for Section 716 which implemented “improvements to processes to reduce financial harm caused to civilians for care provided at military medical treatment facilities”. This section specifically amended Section 1079b of Title 10, United States Code, and is the direct effect of advocacy efforts raising awareness of the financial hardship experienced by some civilian patients after receiving treatment in a military MTF. Some of our Emergency Medicine physicians may be familiar with the plight of civilian trauma patients who were treated at a military MTF and subsequently billed for expenses they could not pay, later learning that the government could withhold Federal Tax Returns as payment for the unpaid medical expenses. While many patients have been grateful for the care that they received at the immediate time of injury, some of these patients went on to become frustrated when income tax refunds were withheld and used to offset the medical expenses incurred during their emergency care. Congressional action was necessary to establish an option for the Director of the Defense Health Agency to waive fees or offer a sliding fee discount program. Section 716 of H.R. 7776 is a step in the right direction to help patients. 

To help guide our future advocacy efforts, the Government Services Chapter launched the 2023 GSACEP Member Engagement Survey on February 1. Members are encouraged to complete the survey within the upcoming month so that their personal experiences and needs can guide the work of our chapter’s Advocacy Committee. Major topics addressed by the survey include our medical practice environment, the technology infrastructure that supports the documentation of medical care, Public Health, and aspects of Diversity, Equity and Inclusion. The survey can be completed anonymously. Those who provide contact information will be enrolled in a raffle for ONE YEAR OF FREE GSACEP CHAPTER ANNUAL DUES! 

Survey responses will help in directing real-time advocacy efforts but most importantly they can be used to also prepare resolutions for the 2023 ACEP Council. Every year, your Government Services Chapter Board Members travel to ACEP in advance of the annual convention. During two long days, representatives from every ACEP Chapter review and debate the resolutions brought forth by state and chapter representatives, and, if supported by a majority of votes, will direct the efforts of ACEP in the year ahead. The topic of resolutions ranges widely and may be related to billing or coding, hiring practices, the role of Advanced Practice Nurses or Physician Assistants, medical care related to reproductive health concerns, and prehospital care to name just a few. 

Additionally, the annual ACEP Leadership and Advocacy Conference (LAC) is coming up soon and is a great opportunity to learn more about how ACEP as a whole is working to advocate for all of its members. The 2023 conference will run from April 30 to May 2. The conference begins with sessions to learn about the key areas that ACEP is focusing their advocacy efforts. The conference schedule reserves time to meet with Senators and Congressional Representatives so it is important that Active Duty members travel on personal leave to participate on their own behalf and not as a representative of their military branch, hospital, or any other entity. While exciting and a great opportunity to meet other ACEP members, it may be challenging for you to attend LAC. Fear not, Regs and Eggs is a weekly blog run by Jeffrey Davis, the Director for Regulatory and External Affairs at ACEP. This blog is written for the non-politician interested in understanding the interface of healthcare and politics. Blog posts include the red tape related to prescribing buprenorphine, Medicaid coverage, violence in the ER, and the No Surprise Act. 

Whether you are new to advocacy work or a seasoned influencer there is always room for you in the Public Relations and Advocacy Committee. Contact the committee through the GSACEP membership forum Tradewing or email to learn more. 

Don’t just take our word for it, follow the links below to learn more:

Geoff Ziezulewicz. Bill could require Pentagon to report opioid prescription rates among TRICARE beneficiaries. Military Times, May 2, 2018

H.R. 5591. 115th Congress. Sharing Health Information to Ensure Lifesaving Drug Safety Act, SHIELDS Act.

H.R. 7776. 117th Congress. James M. Inhofe National, Defense Authorization Act for Fiscal Year 2023

The views expressed in this article are those of the author and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, nor the U.S. Government.

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