NATIONAL HARBOR, MD. – Money issues, notably the Medicare Sustainable Growth Rate formula and ICD-10, dominated deliberations at the American Medical Association Interim House of Delegates meeting.
"The AMA has heard the nation’s physicians, and we’re pulling out the stops to get Congress to act and take a fiscally responsible course that will stop the annual cycle of draconian Medicare cuts and short-term patches," Dr. Ardis Dee Hoven, AMA president, said in a statement after the delegates voted on Nov. 18.
Alicia Ault/IMNG Medical Media
AMA Board at the House of Delegates
There was some dissent over what the AMA should ask for in terms of a replacement for the Sustainable Growth Rate (SGR) formula, but most resolutions relating to alternative approaches were struck down, with one exception: a request that the organization continue to push for annual increases in physician fees going forward.
The AMA previously had indicated its opposition to a provision in the proposal by the Senate Finance Committee and the House Ways and Means Committee to freeze payments for 10 years.
"This year, we have the opportunity to speak with a voice that will actually resonate across the country," said Dr. Richard E. Thorp,president of the California Medical Association. He noted that the House of Delegates had "spent a significant amount of time trying to develop a unified message," which it now had done. "The SGR needs to be put to bed, buried, pour concrete in it. We’ve got to get an end to this thing," said Dr. Thorp.
Dr. Corey Howard, chair of the Florida delegation, agreed. "This is absolutely the right time, with the right message, and it needs to be done now."
AMA delegates also reiterated their concerns about the implementation of the latest iteration of the International Classification of Diseases – ICD-10 – calling for a delay. The coding system is set to launch on Oct. 1, 2014.
"If you like the implementation of the ACA on Oct. 1, 2013, you’re going to love the implementation of ICD-10 on Oct. 1, 2014," said Dr. Gary Bryant, a delegate from the American College of Rheumatology.
The ACR sought a permanent delay to ICD-10 implementation at the House of Delegates annual meeting in June. The House instead approved a resolution calling for the AMA to seek legislation to delay the implementation by 2 years.
The AMA has estimated that it will cost from $83,290 to $2.7 million per practice, depending on size, to implement ICD-10.
The House of Delegates also expressed concern about an Affordable Care Act provision that allows insurers to deny payment for medical care if the patient does not pay his or her health insurance premiums. Under the law, patients can take up to 90 days to pay premiums on policies bought through the health insurance exchanges, yet still get covered services. If the patient skips out on premiums all together, insurers do not have to pay for care that has been provided.
The California delegation offered a resolution to require insurers to pay for services rendered if a patient had eligibility and authorized coverage. The resolution also called on the AMA to oppose efforts to mandate physician participation in exchange plans.
The House voted to support most of the resolution, but in a modification, asked the AMA to advocate that health plans be required to notify physicians that a patient is in the grace period, and which month the patient is in. If physicians are not notified, it would result in a binding eligibility determination for the insurer.
Finally, the delegates called on the Centers for Disease Control and Prevention to collect more detailed data on prescription drug abuse.
"The AMA will urge the CDC to take the lead in promoting a standard approach for documenting and assessing unintentional poisonings and deaths involving controlled substances for pain relief," Dr. Patrice Harris, an AMA board member, said in a statement. "If we are to effectively fight this public health epidemic, we must have a system of data collection and analysis that provides more detailed information on the contributing factors."
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