Recent AMA Policy Changes Affecting Our Specialty
Liana Puscas, MD Chair, AAO-HNS Delegation to the AMA House of Delegates In June, the American Medical Association (AMA) conducted its annual House of Delegates meeting in Chicago. Below are some issues judged to be of increased interest to members of our Academy. Use of Patient Satisfaction Surveys in Determining Physician Payment. Patient satisfaction surveys are increasingly used for both marketing and regulatory purposes. However, spuriously negative surveys can be unfairly detrimental to a physician’s practice. The House of Delegates adopted policy that the AMA work with Centers for Medicare & Medicaid Services (CMS) and non-government payers to ensure that physician payment, when incorporating quality parameters, only consider measures that are under the direct control of the physician. Also, this new policy calls for such surveys to be used only as an adjunctive and not a determinative measure of physician quality for the purpose of physician payment. Scheduling of Hydrocodone. In response to indications from the FDA that it was considering rescheduling hydrocodone from schedule III to schedule II, the AMA adopted policy specifically asking the FDA to keep it as a medication on schedule III of the Controlled Substances Act. There was significant concern that reclassification would restrict access to this common pain medication since schedule II drugs require triplicates and refills are not allowed. Compatibility of EHR systems. The House of Delegates also voted that the AMA will seek legislation or regulation to require all electronic health record (EHR) vendors to utilize interoperable software technology to enable use of EHRs across healthcare delivery systems and community-based settings of care. This policy will result in improved patient care while making it the responsibility of the vendors to ensure interoperability rather than physicians. ICD-10. ICD-10 is scheduled for mandatory implementation by CMS on October 1, 2014. The Cutting Costly Codes Act of 2013 (H.R. 1701) has been introduced in Congress to repeal implementation of ICD-10. The AMA already has policy advocating for delay and repeal of ICD-10. However, should ICD-10 be implemented (or ICD-11 in its stead), the House of Delegates passed another resolution asking insurers for a two-year period in which physician payment would not be denied based on lack of specificity in ICD-10/11 coding. At the meeting, the AAO-HNS delegation consisted of Liana Puscas, MD, chair of the delegation, Michael S. Goldrich, MD, Robert Puchalski, MD, Shannon Pryor, MD, and David R. Nielsen, MD (Academy EVP/CEO and Alternate Delegate). Joy Trimmer, JD, senior director of Government Affairs, Jenna Kappel, director of Health Policy, and Joe Cody, Health Policy analyst, provided staff support. Also of note from this meeting, Dr. Puscas was elected to the AMA’s Council on Medical Education and Dr. Pryor was elected chair of the newly created Women Physicians Section. Prior to the meeting, Dr. Puchalski was elected secretary of AMPAC, the AMA’s political action committee. The next meeting of the AMA House of Delegates will take place November 16-19 in Fort Washington, MD. On the Frontlines: State Legislative Tracking AAO-HNS members are a key resource for tracking state legislation and helping to communicate to policymakers its influence on the specialty and patients. Join the growing team of AAO-HNS state trackers by signing up at govtaffairs@entnet.org to receive daily or weekly legislative tracking updates. If you identify legislation needing Academy action (e.g., letter, action alert, testimony), simply fill out the new online State Action Form at www.entnet.org/Advocacy. Follow Government Affairs on Twitter Do you want to be one of the first to know the status of healthcare bills moving through Congress? Follow the Government Affairs Twitter account @AAOHNSGovtAffrs. By following us, you can learn more about the issues affecting the specialty, including repeal of the flawed Sustainable Growth Rate (SGR) formula, medical liability reform, scope-of-practice battles, Graduate Medical Education (GME) funding, truth-in-advertising initiatives, and efforts to repeal the Independent Payment Advisory Board (IPAB). Not a fan of Twitter? You can also check the Government Affairs webpage for updates at http://www.entnet.org/Advocacy. ENT PAC, the political action committee of the AAO-HNS, financially supports federal Congressional candidates and incumbents who advance the issues important to otolaryngology–head and neck surgery. ENT PAC is a non-partisan, issue-driven entity that serves as your collective voice on Capitol Hill to increase the visibility of the specialty with key policymakers. To learn more about ENT PAC, visit our PAC website at www.entpac.org (log-in with your AAO-HNS ID and password).
Liana Puscas, MD
Chair, AAO-HNS Delegation to the AMA House of Delegates
In June, the American Medical Association (AMA) conducted its annual House of Delegates meeting in Chicago. Below are some issues judged to be of increased interest to members of our Academy.
- Use of Patient Satisfaction Surveys in Determining Physician Payment. Patient satisfaction surveys are increasingly used for both marketing and regulatory purposes. However, spuriously negative surveys can be unfairly detrimental to a physician’s practice. The House of Delegates adopted policy that the AMA work with Centers for Medicare & Medicaid Services (CMS) and non-government payers to ensure that physician payment, when incorporating quality parameters, only consider measures that are under the direct control of the physician. Also, this new policy calls for such surveys to be used only as an adjunctive and not a determinative measure of physician quality for the purpose of physician payment.
- Scheduling of Hydrocodone. In response to indications from the FDA that it was considering rescheduling hydrocodone from schedule III to schedule II, the AMA adopted policy specifically asking the FDA to keep it as a medication on schedule III of the Controlled Substances Act. There was significant concern that reclassification would restrict access to this common pain medication since schedule II drugs require triplicates and refills are not allowed.
- Compatibility of EHR systems. The House of Delegates also voted that the AMA will seek legislation or regulation to require all electronic health record (EHR) vendors to utilize interoperable software technology to enable use of EHRs across healthcare delivery systems and community-based settings of care. This policy will result in improved patient care while making it the responsibility of the vendors to ensure interoperability rather than physicians.
- ICD-10. ICD-10 is scheduled for mandatory implementation by CMS on October 1, 2014. The Cutting Costly Codes Act of 2013 (H.R. 1701) has been introduced in Congress to repeal implementation of ICD-10. The AMA already has policy advocating for delay and repeal of ICD-10. However, should ICD-10 be implemented (or ICD-11 in its stead), the House of Delegates passed another resolution asking insurers for a two-year period in which physician payment would not be denied based on lack of specificity in ICD-10/11 coding.
At the meeting, the AAO-HNS delegation consisted of Liana Puscas, MD, chair of the delegation, Michael S. Goldrich, MD, Robert Puchalski, MD, Shannon Pryor, MD, and David R. Nielsen, MD (Academy EVP/CEO and Alternate Delegate). Joy Trimmer, JD, senior director of Government Affairs, Jenna Kappel, director of Health Policy, and Joe Cody, Health Policy analyst, provided staff support.
Also of note from this meeting, Dr. Puscas was elected to the AMA’s Council on Medical Education and Dr. Pryor was elected chair of the newly created Women Physicians Section. Prior to the meeting, Dr. Puchalski was elected secretary of AMPAC, the AMA’s political action committee.
The next meeting of the AMA House of Delegates will take place November 16-19 in Fort Washington, MD.
On the Frontlines: State Legislative Tracking
AAO-HNS members are a key resource for tracking state legislation and helping to communicate to policymakers its influence on the specialty and patients. Join the growing team of AAO-HNS state trackers by signing up at govtaffairs@entnet.org to receive daily or weekly legislative tracking updates. If you identify legislation needing Academy action (e.g., letter, action alert, testimony), simply fill out the new online State Action Form at www.entnet.org/Advocacy.
Do you want to be one of the first to know the status of healthcare bills moving through Congress? Follow the Government Affairs Twitter account @AAOHNSGovtAffrs. By following us, you can learn more about the issues affecting the specialty, including repeal of the flawed Sustainable Growth Rate (SGR) formula, medical liability reform, scope-of-practice battles, Graduate Medical Education (GME) funding, truth-in-advertising initiatives, and efforts to repeal the Independent Payment Advisory Board (IPAB). Not a fan of Twitter? You can also check the Government Affairs webpage for updates at http://www.entnet.org/Advocacy.
