ACC State Chapters, in concert with ACC Advocacy staff, have been hard at work pushing for state legislative solutions that protect and support both cardiovascular patients and clinicians. Here we roundup victories so far this year, as well as ongoing work to protect access to cardiovascular care and expand heart health education and awareness.

SCA Awareness and Preparedness

In response to Damar Hamlin's sudden cardiac arrest (SCA) on the football field earlier this year, AED-related bills have been trending across the U.S., with 100+ relevant bills being tracked by ACC's State Government Affairs Team. While the ACC has engaged state lawmakers on issues related to AEDs, CPR education and SCA awareness long before this legislative session, the recent uptick in SCA-related bills has presented a prime opportunity for action.

Joining with the National Football League's Smart Heart Sports Coalition in June, the College has been focused on pushing for the adoption of increased CPR education, access to AEDs and emergency action plan requirements across all 50 states, all targeted at protecting the lives of high school student athletes.

The College has built on this increased awareness to advocate for evidence-based policies proven to prevent death from SCA.

While much of the Coalition's work will continue during state legislative sessions in 2024, advocacy efforts are ongoing in several year-round legislatures, including Michigan, Ohio and Pennsylvania.

In Ohio, the ACC Advocacy Team, ACC Ohio Chapter, Coalition partners and other stakeholders have been working to bolster support for legislation, now before the Ohio Senate, that would require AEDs in schools and many municipal sports facilities in the state. Additionally, the bill would mandate the adoption of emergency action plans and training for staff.

Increasing AED access has also become a priority in the state of Maryland, where a state legislator's chief of staff lost their husband due to cardiac arrest outside a restaurant in Annapolis.

Sammy Zakaria, MD, FACC, testified on behalf of the ACC in support of H.B. 288/S.B. 299, a bill requiring food service facilities to have AEDs on site as well as implement a maintenance and training program that aligns with guidelines established by the Maryland Department of Health and Maryland Institute for Emergency Medical Services Systems.

In addition to providing expert testimony, ACC's Maryland Chapter sent multiple letters to chairs of committees and met with several lawmakers to help push the bill across the finish line. The legislation passed with bipartisan support on the last night of Maryland's legislative session.

The ACC Advocacy team will continue to make lifesaving SCA legislation a priority in future state legislative sessions. Keep an eye on ACC.org and in the ACC Advocate newsletter for updates.

Non-Compete Clauses and Restrictive Covenants

Non-compete agreements, and their negative impact on cardiovascular clinicians across the country, have been a priority for several ACC State Chapters this legislative session. The ACC Minnesota Chapter, led by Stephen J. Smalley, MD, FACC, worked with the Minnesota Medical Association to pass S.F. 3025, which stipulates that employers in the state are prohibited from using non-compete clauses in all newly signed employment contracts starting July 1.

The chapter plans to advocate for the inclusion of contracts signed before the implementation of the new law. In Indiana, a bill was signed into law in April banning non-compete agreements for primary care physicians. Although the original bill included all physicians, the legislature ultimately decided to move forward incrementally.

ACC's Indiana Chapter played a vital role in educating lawmakers on how non-competes negatively impact physicians and patients. These discussions helped move the legislation forward, and the chapter will continue advocating to expand the scope of this new law in future legislative sessions.

Non-compete bans have also seen major progress in the state of New York, where S.B. 3100-A passed in the state legislature and now awaits the governor's signature. ACC's New York Chapter strongly supports the bill, launching a grassroots campaign to encourage the governor to sign.

Restrictive covenants and their effect on the field of cardiology remain a significant topic of discussion for ACC's Board of Governors (BOG) and ACC leadership at large. ACC President B. Hadley Wilson, MD, FACC, recently held a Heart-to-Heart conversation on restrictive covenants with several subject matter experts. Click here to access the Heart-to-Heart recording and links to an ACC BOG White Paper on the topic.

Prior Authorization Reform

The popularity of legislation aimed at reducing administrative burden through the reform of health plans' step therapy protocols and praior authorization policies continues to increase. In the state of Washington, the governor signed H.B. 1357, prior authorization legislation that expedites response times for provider requests and determinations and requires payers to integrate prior authorization information into electronic health records.

ACC Washington Chapter Advocacy Chair Ruchi Kapoor, MD, PhD, testified before the Washington State House Appropriations Committee, explaining why reducing administrative burdens by modernizing prior authorization would benefit patients and clinicians. This win came following a years' long grassroots effort from physicians, PAs and patient advocacy organizations as well as negotiations with payers.

Additional State Victories

In South Carolina, the governor signed S.B. 164 into law, a bill that repeals the state's Certificate of Need (CON) law. This bill was a priority for ACC's South Carolina Chapter, working closely with key stakeholders over the past two legislative sessions to pass the best possible bill for all ACC members in the state.

Currently, 35 states and the District of Columbia have CON programs, which according to numerous studies have failed to achieve their intended goal of containing costs. The repeal of CON in South Carolina goes into effect immediately for most health care facilities, including ambulatory surgical centers.

Expanding Medicaid coverage for postpartum care has garnered bipartisan support in many states across the country. This year, both Alaska and Missouri passed legislation to expand coverage from 60 days to 12 months. ACC's Alaska Chapter prioritized this legislation and participated in a grassroots campaign to urge lawmaker support. To date, 36 states have implemented expanded coverage, with Alaska and Missouri both awaiting federal approval.