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Cover Story: Major Actions at American Medical Association

House of Delegates Annual Meeting

Continued from page 1 (adopted.) status quo. This means that failing to Many state societies are disappointed
research are between $500 and $4,000. 7. Repeal and Replace Outdated update the H & P on the day of the pro- that AMA leadership AMA has not taken
These problems are a burden to the infre- Refundable Advanceable Tax Credits - cedure/surgery would be a violation of a more aggressive stance to redress this
quent researcher without institutional Public Option conventional risk management practices. injustice.
support and stifle investigation. The The AMA is currently looking at Tax Testimony did not agree. The Board of 14. Regulation of Physician
AMA has agreed to examine this prob- Credits. The Congressional Budget Trustees Report was referred back for Assistants
lem. (Submitted by Broward County Office concluded in May, 2017, that in further “discussion.” This resolution would oppose
Medical Association.) many areas, tax credits and supplements 12. Oppose Direct to Consumer Physician Assistants from establishing
3. Supervised Injection Facilities were working to provide patients - even Advertising of the American Board of their own licensing Board. Further, it
This is a controversial issue. The those with low expenditures - the ability Medical Specialties (ABMS) “Product” would ask the AMA to develop policy to
municipality or state would create super- to purchase insurance. This stabilized Presently, the American Board of would place ARNPs under the jurisdic-
vised areas where drug addicts could the market in most areas. Internal Medicine (ABIM) and ABMS tion of state licensing boards and devel-
“shoot up” with illegally purchased The House of Delegates decided that post the names of doctors who fail to op model legislation. Since ARNPs desire
drugs in the presence of medical person- the AMA should conduct an in-depth maintain their board certification in the to practice independently, logic would
nel who could provide sterile needles study to examine marketplace stability. form of print media, social media, apps, suggest that they operate with the same
and have Narcan available. They could Testimony from the floor of the House and websites. The ABMS makes unsub- level of skill as physicians and be held to
also enroll drug addicts in drug treat- requested that a “Public Option” be stantiated claims that maintenance of the same medical legal standard.
ment programs. There are currently 92 included as an alternative to Tax Credits certification (MOC) equates to better 15. Reduce Physician Administrative
such facilities in the world. New York to ascertain if the “Public Option” would outcomes. The ABIM has spent $500,000 Burden of MACRA
State and Massachusetts are currently increase competition to the insurance advertising the importance of board cer- This resolution encourages the
studying the advisability of creating marketplace. tification. Testimony strongly opposed Centers for Medicare and Medicaid
these facilities. The benefits are apparent 8. Out-of-Network Care ABMS and ABIM advertising. This was Service and Congress to revise the Merit
with 99 persons losing their lives daily in The House passed a resolution to pro- referred to the Board of Trustees for fur- Based Incentive Payment System (now
the United States. The contrary argu- tect both patients and doctors when out ther study. called QPP) and advocate for scoring
ment is that the state is facilitating malig- of network care is given: 13. Action Steps Regarding adjustments for physicians treating high
nant and illegal behavior. This was - Patients would not be penalized Maintenance of Certification (MOC) risk beneficiaries.
referred for study. when they receive out of network care Perhaps the most contentious issue It should be noted that the AMA has
4. Health Care as a Human Right - Insurers must provide network ade- discussed at the 2017 House of Delegates already been successful in limiting MIPS
The World Health Organization and quacy was MOC. This resolution stated that the reporting to only one benchmark in one
the World Medical Association recognize - Insurers must be transparent AMA recognized lifelong learning for a patient. A physician who complies with
a human right to a basic level of health - Patients protected using the “prudent physician is best achieved by on going this simplified mandate would not be
care. It also asks the AMA to support the layperson” criteria participation in a program of high quali- subject to penalty and reduction in
United Nations Universal Declaration of - Physicians would be compensated ty continuing medical education appro- Medicare Compensation.
Human Rights. Testimony on this resolu- with the criteria of regional “usual and priate to that physician's medical prac- 16. Sale of Insurance Across State
tion was ideologically rich but robustly customary” fees as reported by a bench- tice as determined by the relevant spe- Lines
divided. Referred for Study. marking database. cialty society. This principle is strongly Sale of a health insurance product
5. Expansion of United States - The AMA would develop model leg- supported. However, many Boards across state line would require that the
Veterans’ Health Care Choices islation. exceed this standard and appear interest- policy would be consistent with stan-
Our American Medical Association 9. Physician and Medical Staff ed in their own financial benefit. The res- dards and laws of the state. The patient
would encourage the Veterans Members Bill of Rights (originated by olution was referred to the Board of would have the right to bring the claim
Administration and physicians caring for the Broward County Medical Trustees for further study. in the state where the care was provided.
veterans outside the VA to exchange Association) The AMA has a vast policy involving Also, the insurer would have to ensure
medical records in a timely manner and - The right to be self-governed the issue of MOC. Most delegates feel network adequacy.
include HER interoperability to insure - The right to advocate for its members that the Boards have not done a good job 17. Medicare’s Appropriate Use
prompt care. It also included additional - The right to share in the decision evaluating physician performance. The Criteria (AUC)
funding for the Veterans Choice pro- making of the organization current MOC process is overly expen- Many doctors are unaware that
grams. - The right to engage the healthcare sive, time-consuming and potentially Medicare’s AUC program has already
6. Caps on Federal Medicaid Funding organization’s administration and gov- injurious to physicians, hospital creden- been developed to decrease the number
The House of Delegates voted over- erning body on professional matters tialing, and their careers. of potentially unnecessary and expensive
whelmingly to oppose caps on the (Note: in North Carolina, 8 hospitals The Medical Society of Pennsylvania tests: especially imaging. This resolution
Medicaid program. have de-credentialed their medical staffs had a 90 minute panel discussion that asks the AMA to advocate to delay the
A second complicated resolution con- and stripped them of their authority: A documented the blatant unfairness of effective date of the Medicare AUC pro-
cerning coverage for children, amount of violation of Joint Commission policy.) ABIM and ABMS practices. Testimony gram. Until CMS can adequately assess
funding for each state, potential down- This Board of Trustees report was suggested that the Boards are more inter- how the QPP affects the use of advanced
side of cost-saving mechanisms, should adopted with minimal modification on ested in their own financial inurnment. diagnostic imaging, implementation
not decrease patient access to quality the floor of the House of Delegates. Their conduct has been scandalous would be delayed. The AMA is afraid
care or physician payment. To continue, 10. Reimbursement for Translation including obtaining a federal injunction that AUC will place another time con-
federal funding should be based on the Services against a doctor who had started a review suming burden on already stressed
cost to each state and should continue to The AMA would work to reduce the course. The ABIM went so far as invad- physicians and lead to physician
be funded based at current Medicaid burden of the costs associated with ing his house and confiscating his com- burnout. Moreover, compliance may not
expansion levels. Also, the government translation services as implemented puters. be very difficult on physicians with HER.
would continue to monitor the impact under Section 1557 of the Affordable Another doctor (pediatrician) who had Small practices, lacking EHR will find
on services. (This section was referred Care Act. complied with all of modules and passed this particularly burdensome.
for study.) 11. Eliminate Requirement for the written MOC was dropped from
The final resolution, advocated that History and Physical Update - Board of Board status and lost her Blue Cross con- Dr. Arthur Palamara, Board of Directors,
Congress and the Department of HHS Trustee Report tract because she refused to pay an addi- Broward County Medical Association.
should take input from the AMA, State Testimony was mostly negative on tional $1,600. (Her status was restored For more information, visit
Societies, and other interested groups. their report which found reasons for the when she paid.) www.bcma.com.

Coming Next Month...

• Profiles in Leadership & Administration • Healthcare Professionals Associations
• Education Update – New Programs in Healthcare Education

• Outsourcing Update • Revenue Cycle Software Trends

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8 July 2017 southfloridahospitalnews.com South Florida Hospital News