AMA House of Delegates report: Issues impacting otolaryngology

February 2019 – Vol. 38, No. 1

Douglas R. Myers, MD
Chair of the AAO-HNS Delegation to the AMA House of Delegates

The American Medical Association (AMA) held its 2018 Interim House of Delegates (HOD) Meeting November 9-13, at National Harbor, MD. The American Academy of Otolaryngology–Head and Neck Surgery was represented by Delegation Chair Douglas R. Myers, MD; Delegate Robert Puchalski, MD; Delegate Craig S. Derkay, MD; Alternate Delegate Susan D. McCammon, MD; and Alternate Delegate James C. Denneny III, MD, AAO-HNS EVP/CEO.

Below is a summary of the debated reports and resolutions most relevant to our specialty.

Opposition to mandatory licensing requirements for qualified clinical data registries

The AAO-HNS co-sponsored this resolution with 21 other specialty societies in response to a proposal by the Centers for Medicare & Medicaid Services (CMS) that, as a condition of a QDCR measure’s approval for purposes of MIPS quality reporting, QDCR owners would be required to enter into a license agreement with CMS to provide the measure free of charge to other QCDRs. That proposal was made contrary to CMS’ policy to protect the intellectual property rights of QCDR measure owners.  Amendments made during the meeting did not detract from the resolution’s intent.

Site of service payment differential

This report from the Council on Medical Services supported Medicare payment policies that are site-neutral without lowering total Medicare payments. It further called for payments (which for private practices and ambulatory surgery facilities have not kept up with medical cost inflation) to be based on the actual costs of the service. The report was approved.

Ban on tobacco flavoring agents

This resolution from the American Thoracic Society, Society of Critical Care Medicine, and the American College of Chest Physicians originally called for preventing flavorings from being added to electronic cigarette solutions or other tobacco products unless they are proven to not be toxic. Because of their role in luring a new generation of youth into the use of nicotine, the HOD passed an amended version that called for a ban of all tobacco product flavorings. There was strong sentiment to prohibit access to tobacco products by anyone under 21 years of age, which is current AMA policy.

Addressing surgery performed by optometrists

The states of Louisiana, Kentucky, and Oklahoma have allowed optometrists to perform anterior chamber ophthalmic laser surgery as well as several scalpel surgeries. Graduates of optometric schools from other states who have had no surgical experience may obtain licensure to perform surgery in the three states noted above by completing a 16-hour course.  The resolution submitted by the American Academy of Ophthalmology calling for state and federal laws prohibiting optometrists from performing surgery received wide support in the HOD and was passed without amendment.

The next meeting of the AMA HOD will be June 8-12, in Chicago, IL. If you have questions regarding this report and other AMA HOD activities, contact