After sending a joint letter that outlined ACEP’s concerns with CMS’ interpretive guidelines on what constitutes anesthesia and who is “qualified” to administer it, ACEP, the Emergency Nurses Association (ENA), and the American Association of Emergency Medicine (AAEM) met April 19 with CMS Survey and Certification staff requesting an exception for emergency departments.
I participated in this meeting, as did ACEP Board Member Dr. David Seaberg and ACEP Committee Chair Dr. Kevin Klauer, along with ENA and AAEM representatives.
CMS staff acknowledged the emergency medicine concerns, emergency physician training in sedation and airway management, and the unique environment of emergency departments, with all un-scheduled patient needs.
After the meeting, additional clinical literature was sent to CMS.
“We didn't expect a response to our request for an exception for EDs at the time of the meeting, but are hopeful that revisions will be made to language as it relates to emergency medicine,” said Barbara Tomar, ACEP’s Federal Affairs Director.
“We will post something to the ACEP website as soon as we hear from CMS, which may be a few months,” she added.
ACEP's current policy on procedural sedation defends the use of Propofol by emergency physicians and can be reviewed at http://acep.org.