AMA House of Delegates

AMA meeting: Congress is urged to stop automatic cuts to health programs

Delegates direct the AMA to lobby Congress to prevent budget reductions in Medicare, public health and other initiatives.

By Charles Fiegl amednews staff — Posted Nov. 26, 2012

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The American Medical Association will push Congress to develop a plan that rescinds cuts to federal health care programs in future years.

At its Interim Meeting in November, the House of Delegates directed the AMA to advocate that lawmakers develop a fiscally responsible alternative to the automatic budget sequestration cuts endangering medical research, work force programs, food and drug safety, and health care for uniformed service members. Legislation also should address sequestration of Medicare payments to graduate medical education programs, hospitals and physicians that will endanger access to care and training of physicians, the directive stated.

Physician testimony during a Nov. 11 reference committee session unanimously supported the resolution introduced by the American College of Physicians, American Assn. of Neurological Surgeons, American Academy of Family Physicians and several other organized medicine groups.

Under law, federal budget deficits must be cut by $1.2 trillion beginning in 2013 and throughout the next eight years. Congress and President Obama had agreed to reduce spending across the board during 2011 negotiations to raise the federal debt ceiling.

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Dr. Ejnes

The automatic, across-the-board reductions are divided between defense and nondefense spending. Medicaid and Social Security are protected from the cuts, but Medicare payments are not, and pay for physician services would be lowered by 2%.

The sequestration of federal health programs is not limited to Medicare, said Rhode Island internist Yul D. Ejnes, MD, a delegate for the American College of Physicians. The budget mechanism will affect federal drug safety programs, physician work force growth initiatives and care to dependents of military personnel.

“Given the broad scope of sequestration and its impact on our patients and the work we do, we thought it was important to submit this resolution to get the message out in a timely manner to the Congress,” Dr. Ejnes said during reference committee testimony.

Public health programs, which already have marginal support in Washington, are another area that will be damaged by the budget sequester, said AAFP President-elect Reid B. Blackwelder, MD, a family physician from Kingsport, Tenn. Cuts will only exacerbate unmet health care needs, he said.

“We do need fiscal responsibility, but our representatives' responses must be proactive and informed,” Dr. Blackwelder said.

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Meeting notes: Legislative action

Issue: A transition to the ICD-10 diagnosis code sets represents a significant hardship and will increase the bureaucratic and financial burden on physicians.

Proposed action: The American Medical Association will reiterate to the Centers for Medicare & Medicaid Services that the burdens imposed by ICD-10 will force many physicians in small practices out of business. The communication will be sent to all in Congress and displayed on the AMA website. [Adopted]

Issue: The Supreme Court's decision on the 2010 health system reform law gave states the option, instead of a federal mandate, to expand Medicaid eligibility.

Proposed action: The AMA, at the invitation of state medical societies, will work with state and specialty medical societies on advocating that state governments expand Medicaid eligibility. [Adopted]

Issue: Pay-for-delay practices involve drug manufacturers paying other drug companies not to release generic versions of their medications.

Proposed action: The AMA will support federal legislation to ban pay-for-delay practices in the drug industry. [Adopted]

Issue: Medicare quality and resource use reports employ cost measurements based on spending for patients that often are related to care provided by other physicians.

Proposed action: The AMA will continue to work with CMS to improve the reports' design, content and performance indicators so they reflect the quality and cost associated with these other physicians when calculating value-based payment modifiers. [Adopted]

Issue: New technologies enable rapid genome sequencing in the clinical setting, but there are implementation challenges that still need to be addressed. [Adopted]

Proposed action: The AMA will recognize the utility of next-generation sequencing. It will support regulatory policy that protects patient rights and confidentiality, and gives physicians access to such diagnostic tools when clinically appropriate. [Adopted]

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