PLEASE NOTE: THIS RESOLUTION WILL BE DEBATED AT THE 2011 COUNCIL MEETING. RESOLUTIONS ARE NOT OFFICIAL UNTIL ADOPTED BY THE COUNCIL AND THE BOARD OF DIRECTORS (AS APPLICABLE). RESOLUTION: 27(11) SUBMITTED BY: Georgia College of Emergency Physicians SUBJECT: Tax Relief for Uncompensated/Undercompensated Medical Care PURPOSE: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Investigate federal tax relief for medical professionals that provide medical services to uninsured and underinsured patients. WHEREAS, Congress has repeatedly failed to repair the damaged Sustainable Growth Rate (SGR) after many years of threatened cuts; and WHEREAS, Medical professionals including primary care, specialists, hospitals, and others who receive government reimbursement have difficulty making fiscal plans when Congress continues failing to act on a permanent solution; and WHEREAS, Physicians often limit the numbers of uninsured or underinsured patients they accept because of low reimbursement rates; and WHEREAS, Many patients have great difficulty finding a physician who will accept Medicare or uninsured patients because of these limits; therefore be it RESOLVED, That ACEP investigate avenues for federal tax relief for medical professionals that provide medical services to uninsured and underinsured patients. Background The resolution directs ACEP to investigate the possibility of obtaining tax relief for medical professionals who provide medical services to uninsured and underinsured patients. ACEP has been a leading advocate for funding the EMTALA-mandate and/or provide tax credits to those who provide EMTALA-related. In the 110th Congress, ACEP supported two bills to provide tax deduction for uncompensated emergency medical care. The first bill, “Mitigating the Impact of Uncompensated Service and Time (MUST) Act of 2007” (HR 1233), was introduced by Rep. Mary Bono Mack (R-CA). The bill had six cosponsors and was referred to the House Ways and Means Health Subcommittee, but no further action was taken. The second bill, “Treat Physicians Fairly Act of 2007” (HR 3344), introduced by Rep. Ron Paul (R-TX), did not receive any additional support and was referred to the House Ways and Means Committee. In the 111th Congress, both of the two previously mentioned bills were reintroduced. The MUST Act (HR 1678) ended with 10 co-sponsors and a referral to the House Ways and Means Committee. The Treat Physicians Fairly Act (HR 1497) ended with no co-sponsors and a referral to the House Ways and Means Committee. In this 112th Congress, ACEP has been working to gain support from Reps. Bono Mack and Ron Paul. Rep. Bono Mack has expressed a willingness to reintroduce the bill, but her office has yet to take action. Rep. Paul’s office is not inclined to reintroduce the bill at this time. We have also discussed this concept, and the possibility of introducing similar legislation, with Rep. Joe Heck’s office. We have heard no response on this matter to date. Resolution 27(11) Tax Relief for Uncompensated/Undercompensated Medical Care Page 2 ACEP Strategic Plan Reference Goal 3 – Ensure Fair Reimbursement Fiscal Impact None other than budgeted staff time and consultant time covered under existing contracts. Prior Council Action Amended Resolution 34(02), Funding for EMTALA-Mandated Physician Services adopted. Directed the College to seek federal legislation to fund uncompensated EMTALA-mandated medical services and to form a coalition including the AMA and other medical organizations to lobby for new funds that address physician costs of complying with EMTALA requirements. Amended Substitute Resolution 30(01) Inconsistent EMTALA Enforcement adopted. Directed ACEP to solicit member input to formulate EMTALA recommendations to CMS’ regulatory advisory committee including physician on-call responsibilities, greater consistency of enforcement, and more effective involvement of peer review organizations. Substitute Resolution 29(01) Funding of Emergency Care for Foreign Nationals adopted. It called for ACEP to reaffirm that uncompensated costs of treating foreign nationals as part of the health care safety net, which adds to the financial strain of EMTALA compliance. Resolution 26(01) Emergency Care as an Essential Public Service adopted. Directed ACEP to champion the principle that emergency care is an essential public service. Amended Substitute Resolution 15(00) EMTALA adopted. Directed the College to work with appropriate organizations and agencies to improve EMTALA requirements. Amended Resolution 15(99) Promotion of Health Care Insurance adopted. Directed the College to develop a strategic plan to promote expansion of health insurance coverage for the uninsured and underinsured; make a long-term commitment to work with federal, state, and private agencies to resolve the problem; and provide a progress report at the 2000 Council meeting. Amended Resolution 11(92) Payment for Mandated Services adopted. Directed the College to support that any government agency, legislative body, insurance carrier, third party payer, or any other entity which mandates that a service or product be provided by emergency physicians or other providers, also mandate an adequate source of funding to ensure appropriate compensation for those services or products and to pursue appropriate legislation to ensure that any governmental agency, legislative body, insurance carrier, third party payer or any other entity which mandates the provision of medical services or products, also provides for appropriate compensation for that service or product. Prior Board Action April 2011, reaffirmed the policy statement, “Compensation When Services are Mandated.” http://www.acep.org/Content.aspx?id=47148 The policy statement was originally in 1999 and reaffirmed in September 2005. Amended Resolution 34(02), Funding for EMTALA-Mandated Physician Services adopted. Amended Substitute Resolution 30(01) Inconsistent EMTALA Enforcement adopted. Substitute Resolution 29(01) Funding of Emergency Care for Foreign Nationals adopted. Resolution 27(11) Tax Relief for Uncompensated/Undercompensated Medical Care Page 3 Resolution 26(01) Emergency Care as an Essential Public Service adopted. Amended Substitute Resolution 15(00) EMTALA adopted. Amended Resolution 15(99) Promotion of Health Care Insurance adopted. June 1999 approved the revised policy statement, “Compensation When Services are Mandated.” Amended Resolution 11(92) Payment for Mandated Services adopted. Background Information Prepared By: Gordon Wheeler, Associate Executive Director, Public Affairs Reviewed by: Arlo F. Weltge, MD, FACEP, Speaker Marco Coppola, DO, FACEP, Vice Speaker Dean Wilkerson, JD, MBA, CAE, Council Secretary and Executive Director