American Medical Assoc. Adopts New Policies at Interim Meeting

CHICAGO — The American Medical Assoc. (AMA), the nation’s largest and most influential physician organization, voted during its recent policy-making meeting to adopt the following new items to its healthcare agenda:

Refill Schedules

The Centers for Disease Control estimates that half of American adults suffer from a chronic disease, which often requires treatment with multiple medications. A recent report showed that an increasing number of medications and the logistics of retrieving prescriptions from a pharmacy are associated with decreased medication adherence.

As a result, the AMA-adopted policy encouraging relevant organizations to develop a plan to implement prescription-refill schedule strategies so that patients requiring multiple prescription medications may reduce travel barriers to get their medications.

Medicaid Expansion

The Supreme Court’s decision on the Affordable Care Act determined that it is optional for states to expand Medicaid eligibility to 133{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of the federal poverty level (FPL). Newly adopted policy calls on the nation’s largest physician organization, at the invitation of state medical societies, to advocate at the state level to expand Medicaid eligibility to 133{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of the FPL.

The new policy also calls on the AMA to advocate for an increase in Medicaid payments to physicians and improvements and innovations in Medicaid that will reduce administrative burdens and deliver healthcare services more efficiently, even as coverage is expanded.

Genomic Sequencing

New technologies have been developed that enable rapid genome sequencing in the clinical setting for dramatically reduced costs, but implementation challenges must be addressed in order to fully realize the potential of these technologies to improve health outcomes.

Policy adopted by the AMA recognizes the utility of next-generation sequencing technologies and supports regulatory policy that protects patient rights and confidentiality, and enables physicians to access and use such diagnostic tools as clinically appropriate. The policy also calls on the AMA to inform and educate physicians and physicians-in-training on the clinical uses of these technologies.

Hepatitis C Strategy

An estimated 3.2 million Americans are currently infected with the hepatitis C virus (HCV), and the CDC estimates that more than half of those are unaware that they have the virus. More than 2 million of the 3.2 Americans infected with hepatitis C are estimated to have been born between 1945 and 1965. Recent studies have shown that birth-year-based screening is an extremely cost-effective way of testing for hepatitis C.

New AMA policy encourages the implementation of birth-year-based screening practices for hepatitis C in alignment with recent CDC recommendations. The policy also encourages the CDC and state departments of Public Health to develop and coordinate hepatitis C infection education and prevention efforts.

Violence at Work

The AMA’s board of trustees presented a report on violence in the non-hospital work environment. A survey found that 12{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of the physician respondents reported that they were a victim of at least one incident of workplace violence in the past 18 months. About 5{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} were victims more than one time. The most commonly reported form of abuse was categorized as verbal (70{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}).

Facilitating Generic Drugs

The AMA adopted policy to end the practice of ’pay for delay’ in prescription medicine. Pay for delay refers to the practice of brand-name prescription-drug manufacturers paying generic drug manufacturers for not creating generic versions of their medication. This limits the number of prescription options available to patients and contributes to the growth in healthcare costs.

“Pay for delay keeps quality, low-cost generic drugs out of the marketplace and unnecessarily drives up costs for patients,” said AMA board member Dr. Patrice Harris. “In order to ensure the most cost-effective treatment options, this practice must stop.”

Tdap Vaccines

The AMA also passed policy to urge Medicare to cover Tdap (tetanus, diptheria, and acellular pertussis) vaccines under Medicare Part B. Tdap vaccinations are currently not reimbursed under Medicare Part B, and rates of pertussis, also known as whooping cough, are on the rise.

Unpaid Student-loan Debt

Policy was adopted by AMA’s house of delegates to seek federal legislation or regulatory changes to stop Medicare and Medicaid from decertifying physicians due to unpaid student-loan debt. The current practice of decertifying physicians with outstanding loan debt stops them from accepting Medicare and Medicaid patients and undermines their ability to repay student loans.