Delegate’s Report- AMA Interim Meeting 2023
By David Bensema, MD, MBA, FACP
I returned late the evening of November 14 from an eventful five days at the 2023 Interim Meeting of the American Medical Association (AMA) at National Harbor, Maryland, just outside our nation’s capital. Our Kentucky Medical Association (KMA) Delegates and Alternate Delegates were kept busy, monitoring proposed resolutions and advocating both behind the scenes and in reference committees for issues that align with the policies of our KMA and support the continued autonomy of our medical decision making and reduced burdens on physicians. I am copying and pasting below an excellent summary of the outcomes of the House of Delegates’ deliberations from our AMA Advocacy team.
Medicare physician payment was a top priority for delegates—especially considering the 3.37% in payment cuts that, absent congressional intervention, are set to take effect in January. The House of Delegates adopted new policy to “continue to prioritize reforming the Medicare payment system to ensure the continued economic viability of medical practice”—with specific focus on stopping the 3.37% cut and achieving sustainable annual Medicare payment increases.
“When a system becomes so broken that, year after year, it places greater financial pressure on physicians—in fact penalizing them for providing care to Medicare patients —we cannot simply shrug our shoulders and ignore. The cuts are too deep, too relentless, and they touch too many lives—physicians and patients alike,” said AMA President Jesse M. Ehrenfeld, MD, MPH, in his speech to the House of Delegates.
The following are some of the other key issues that were discussed at the meeting:
- Prior authorization: Directed the AMA to advocate to ensure that only physicians who are trained, licensed and qualified to diagnose medical conditions or determine medical necessity perform prior authorization.
- Scope of practice: Reaffirmed existing policy to maintain the authority and oversight of state medical boards in the regulation nonphysician health professionals, and also reaffirmed policy on Truth in Advertising.
- Drug overdose epidemic: Called for elimination of dose limits on buprenorphine treatment for patients with opioid use disorder.
- Medical decision making: With the rise in health care administrator positions and physician employment, adopted policy to “continue to strongly oppose any encroachment of administrators upon the medical decision-making of attending physicians that is not in the best interest of patients.”
- National drug shortages: Adopted policy in support of diversifying drug manufacturing and supply chains and stabilizing the generic drug market, as well as in opposition to practices such as pharmacy benefit manager formulary restrictions.
- Network inadequacy: Adopted new policy to “support establishment and enforcement of a minimum network adequacy standard requiring all health plans to contract with sufficient numbers and types of physicians and other providers, including for mental health and substance use disorder, such that both scheduled and unscheduled care may be provided without unreasonable travel or delay.”
- Patient cost-sharing collection: Adopted policy to reduce the burden of cost-sharing on physicians by requiring health insurers to collect patient cost-sharing.
- Pluralism in health reform: Maintained opposition to single payer health reform.
Additionally, we continue to celebrate the election of and look forward to the leadership of Bruce Scott, MD, Louisville as President of our AMA, beginning in June 2024. We are a small, four delegates, delegation, but as our own Dr. Ardis Hoven, AMA President 2013-2014 says, “We are small but mighty!” This strength is further proven by the Presidency of our own Dr. Steve Stack 2015-2016, whose leadership continues to shine as our Commonwealth’s Commissioner for Public Health and now as President-Elect of the Association of State and Territories Health Officers (ASTHO), the national organization representing public health officers. We have a strong presence and meaningful impact at the AMA, but we would like to do more for you and all the physicians we are privileged to represent.
Your KMA delegation to our AMA continues to work diligently to represent your interests. Our efforts would be enhanced by having one or two more delegates. To achieve that we need more AMA members. I understand that no organization perfectly aligns with my or your point of view on every issue, but I know that without our participation and advocacy the alignment will never improve and issues that are pertinent to physicians in Lexington, Kentucky, and our nation will not be adequately represented. Please join me in the AMA and encourage your colleagues to join our KMA and the AMA, to help increase our voice and impact for our patients and profession.
David J. Bensema, MD, MBA
Delegate to the American Medical Association