As 2021 brings a new Congress and administration to Washington, DC, it also brings new state legislative sessions, with 38 states and DC meeting as of this week. ACC State Chapters and ACC State Government Affairs are already working on crucial legislative issues across the country. Here's a preview of some of the issues affecting cardiovascular care that states are expected to consider this year:

COVID-19 Liability Protections: There is an ongoing need in many states to address health care worker liability protections during the pandemic. This includes protections for care delivered in direct response to COVID-19 patients under surge conditions, as well as for care that may have been delayed or denied in response to government directives restricting elective and nonemergency procedures.

Telehealth: The COVID-19 public health emergency led to significant telehealth expansion, with the federal government and states rolling back limitations around services delivered through audio-only phone calls, suspending restrictions that prevented patient care delivered by telehealth in patients' homes, and loosening licensing rules around care delivered across state lines. Many payers expanded their coverage of telehealth as well. However, most of these measures are temporary and states will be considering long-term changes for the post-pandemic use of telehealth including whether it will be reimbursed at the same level as care delivered in person.

Public Health Initiatives: States plan to continue addressing tobacco use and prevention through legislation. ACC's State Advocacy team anticipates that several states will introduce bills to increase tobacco taxes, especially in states needing to generate revenue in response to the pandemic. Restricting and/or eliminating the sale of flavored tobacco products and electronic cigarettes will also continue to be a hot topic in state legislatures.

Telephone CPR is an emerging issue that will be in play this session; it requires 911 telecommunicators that provide dispatch for emergency medical conditions be trained in the delivery of high-quality telephone CPR. The training follows evidence-based, nationally recognized guidelines for high-quality telephone CPR. Similarly, legislation requiring high school students to receive CPR training as a condition for graduation will remain a priority. Ten states have yet to pass this legislation.

Prior Authorization Reform: While progress has been made at the state level, the work will continue in several states this year to pass legislation that improves transparency, standardization and efficiency of prior authorization processes.

Follow ACC state advocacy activities on social media, @Cardiology and #ACCGrassroots for ongoing updates.

Clinical Topics: COVID-19 Hub

Keywords: ACC Advocacy, Coronavirus, severe acute respiratory syndrome coronavirus 2, COVID-19, Electronic Nicotine Delivery Systems, Tobacco, State Government, Federal Government, Public Health, Prior Authorization, Telemedicine, Tobacco Use, Cardiology Magazine

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