NEW ORLEANS – The American Medical Association’s policy-making body wrapped up 2 and a half days of meetings Nov. 15 by calling for a delay in implementation of the ICD-10 coding system, and reiterating its intention to seek the ability to privately broker fees with Medicare patients.
Physicians have long sought to be allowed to engage in so-called "private contracting" with Medicare patients. Under that scenario, Medicare patients could use their benefits to see a physician that does not accept Medicare. Currently, patients have to pay for the entire visit out of their pocket if their physician does not accept Medicare.
The AMA says private contracting will empower patients – and, the group is supporting legislation sponsored by Rep. Tom Price (R-Ga.) that would allow such private contracting. The Medicare Patient Empowerment Act (H.R. 1700) was introduced in May; a companion bill was quickly introduced in the Senate by Lisa Murkowski (R-Alaska).
The AMA House of Delegates reaffirmed support of the legislation, but also called upon the AMA to start a grassroots campaign to get patients involved.
"This is a directive to take action," said Dr. Corey Howard, lead delegate from the Florida delegation, which initiated the resolution seeking a public campaign. "It’s time to start planting those seeds to help the public begin to look at this in a favorable way."
Alabama delegate Dr. Jeff Terry and president of the Medical Association of the State of Alabama said, "A grassroots campaign will allow our politicians to do the right thing." Such a campaign will let politicians know "that we don’t want our congressmen to walk out on a political limb not supported by the public."
The emphasis on private contracting was in part a symptom of the high-pressure environment physicians find themselves in, facing a potential 27% cut in Medicare payments as well as high-cost requirements to implement electronic medical records, said Dr. Robert Wah, chairman of the AMA Board of Trustees.
"The fact that patients may be able to take their benefit where theyd like to, to see the doctors they want to see, is a potential safety valve to all this pressure being exerted on physician practices and patients in the Medicare system," Dr. Wah said in an interview. "So we’re actively pushing at the local level for people to go to their congressmen and ask them to sign on to this legislation."
The push back against the coming implementation of the new ICD-10 coding system in 2013 is also a symptom of physicians feeling overwhelmed by their changing practice environment, Dr. Wah said. The House approved a resolution sponsored by the Alabama and Mississippi delegations, along with the American Urological Association and American Association of Clinical Urologists, to take action to stop the implementation.
The ICD-10 will consist of 69,000 codes, as compared with the 14,000 in ICD-9, currently in use.
"At a time when we are working to get the best value possible for our health care dollar, this massive and expensive undertaking will add administrative expense and create unnecessary workflow disruptions," AMA President Peter W. Carmel said in a statement.
The ICD-10 system has been in development for 10 years but has been delayed several times already. The House of Delegates called on the AMA to mount "a vigorous campaign to seek delay of the implementation date," according to Dr. Wah.