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Michigan Delegation to the AMA Interim Meeting Report

Thursday, November 21, 2019

On November 19, the Michigan Delegation to the American Medical Association (AMA) wrapped up another successful AMA Interim Meeting.  From Council representation to testimony to serving on Reference Committees, Michigan’s Delegation worked hard to influence national health care policy.

In addition to bringing forth resolutions passed by the MSMS House of Delegates, the Delegation monitored and provided testimony on a variety of issues heard by six Reference Committees.  Sixty-seven resolutions, seventeen Board of Trustee Reports, and nineteen AMA Council Reports were reviewed and discussed over the course of the four-day meeting.

“I commend the Michigan Delegation for their preparation to ensure the voice of Michigan physicians is well represented at the AMA House of Delegates,” said Mark C. Komorowski, MD, Chair of the Michigan Delegation.  “I am proud of their advocacy and dedication.”

Michigan submitted eight resolutions and one memorial resolution recognizing Bassam H. Nasr, MD.  As always, Michigan’s resolutions touched on timely topics and generated a great deal of support.  Below is a listing of the resolutions and outcomes.

 No. Title  Final Action 
10 Ban Conversion Therapy Adopted as Amended.

RESOLVED, That our American Medical Association develop model state legislation and advocate for federal legislation to ban "reparative" or “conversion” therapy for sexual orientation or gender identity.

11 End Child Marriage Adopted as Amended.

RESOLVED, That our American Medical Association oppose the practice of child marriage by advocating for the passage of state and federal legislation to end the practice of child marriage.

211 Effects of Net Neutrality on Public Health Referred.
212 Centers for Medicare and Medicaid Services Open Payments Program Adopted as Amended.

RESOLVED, That our American Medical Association amend current policy H-140.848, “Physician Payments Sunshine Act,” by addition and deletion to read as follows: Our AMA will: (1) continue its efforts to minimize the burden and unauthorized expansion of the Sunshine Act by the Centers for Medicare & Medicaid Services (CMS) and will recommend to the CMS that a physician comment section be included on the "Physician Payments Sunshine Act" public database; (2) lobby Congress to amend the Sunshine Act to limit transfer of value reporting to items with a value of greater than $100; (3) advocate that: (a)(i) any payment or transfer of value reported as part of the Physician Payments Sunshine Act should include whether the physician acknowledged receipt of said payment or transfer of value, and (ii) each payment or transfer of value on the Open Payments website indicates whether the physician verified the payment or transfer of value; and (b) a contested reported payment or transfer of value should be removed immediately from the Open Payments website until the reporting company validates the compensation with verifiable documentation.; and (4) support significant modifications to the Sunshine Act,  such as substantially increasing the monetary threshold for reporting, that will decrease the regulatory and administrative burden on physicians, protect physician rights to challenge false and misleading reports, change the dispute process so that successfully disputed charges are not included publicly on the Open Payments database, and provide a meaningful, accurate picture of the physician-industry relationship; (5) support the expansion of the definition of “covered recipients” to include pharmacists and Pharmacy Benefit Managers; and (6) continue to educate physicians about the Sunshine Act and its implications in light of publicly available data on the CMS Open Payments Program website.

811 Require Payers to Share Prior Authorization Cost Burden Adopted.

RESOLVED, That our American Medical Association (AMA) reaffirm AMA policies H-320.939, Prior Authorization and Utilization Management Reform, and H-385.951, Remuneration for Physician Services.

922 Understanding the Effects of PFAS on Human Health Alternate Resolution 901 Adopted in lieu of Resolutions 901 and 922.

RESOLVED, That our American Medical Association: (1) support continued research on the impact of perfluoroalkyl and polyfluoroalkyl chemicals on human health; (2) support legislation and regulation seeking to address contamination, exposure, classification, and clean-up of PFAS substances; and (3) advocate for states, at minimum, to follow guidelines presented in the Environmental Protection Agency’s Drinking Water Health Advisories for perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS), with consideration of the appropriate use of Minimal Risk Levels (MRLs) presented in the CDC/ATSDR Toxicological Profile for PFAS.

923  Support Availability of Public Transit Systems Adopted as Amended.

RESOLVED, That our American Medical Association amend current policy H-135.939, “Green Initiatives and the Health Care Community,” by addition and deletion as follows: Our AMA supports: (1) responsible waste management and clean energy production policies that minimize health risks, including the promotion of appropriate recycling and waste reduction; (2) the use of ecologically sustainable products, foods, and materials when possible; (3) the development of products that are non-toxic, sustainable, and ecologically sound; (4) building practices that help reduce resource utilization and contribute to a healthy environment; (5) the establishment, expansion, and continued maintenance of affordable, accessible, barrier-free, reliable, and clean-energy public transportation; and (6) community wide adoption of 'green' initiatives and activities by organizations, businesses, homes, schools, and government and health care entities; and be it further

RESOLVED, That our American Medical Association amend current policy H-425.993, “Health Promotion and Disease Prevention,” by addition and deletion as follows: The AMA (1) reaffirms its current policy pertaining to the health hazards of tobacco, alcohol, accidental injuries, unhealthy lifestyles, and all forms of preventable illness; (2) advocates intensified leadership to promote better health through prevention; (3) believes that preventable illness is a major deterrent to good health and accounts for a major portion of our country's total health care expenditures; (4) actively supports appropriate scientific, educational and legislative activities that have as their goals: (a) prevention of smoking and its associated health hazards; (b) avoidance of alcohol abuse, particularly that which leads to accidental injury and death; (c) reduction of death and injury from vehicular and other accidents; and (d) encouragement of healthful lifestyles and personal living habits; (5) advocates that health be considered one of the goals in transportation planning and policy development including but not limited to the establishment, expansion, and continued maintenance of affordable, accessible, barrier-free, reliable, and preferably clean-energy public transportation; and (6) strongly emphasizes the important opportunity for savings in health care expenditures through prevention.
924  Update Scheduled Medication Classification  Not Adopted.

Rationale: The Council on Science and Public Health noted that two drug schedules currently distinguish narcotics (opioids) from non-narcotics drugs, Schedule II/IIN and Schedule III/IIIN.  The “N” designation indicates a non-narcotic drug.

 


As noted by the number of reports presented, your BOT and Councils worked diligently to respond to the directives of the House of Delegates and their constituencies. Michigan Delegates Betty S. Chu, MD, MBA, and Pino D. Colone, MD, serve on the Council on Medical Service and Constitution and Bylaws, respectively. Michigan Alternate Delegate Christie Morgan, MD, began her term as Immediate Past Chair of the AMA-Young Physicians Section Governing Council for the 2019-20 term.

Michigan’s presence was also evident as several members served on Reference and other committees:

  • David T. Walsworth, MD – Chair, Constitution and Bylaws
  • Venkat K. Rao, MD – Member, Reference Committee C (Medical Education)
  • Michael D. Chafty, MD – Member, Reference Committee F (AMA Finance and Governance)
  • Patricia A. Kolowich, MD – Member, Reference Committee K (Advocacy Related to Medical Education, Science and Public Health Issues)
  • Amit Ghose, MD – Member, Committee on Rules and Credentials

Other highlights from the AMA Interim Meeting include:

  • Adoption of concise policy in support of banning the sale and distribution of all e-cigarette and vaping products lacking FDA approval for tobacco-cessation purposes and made available by prescription only.
  • Commitment to improving and support of racial pay equality.
  • Recognition of the need to provide current and future physicians with awareness and training necessary to better treat patients facing health issues related to sexual orientation and gender identity.
  • Adoption of the Council on Ethical and Judicial Affairs Report 1 titled Competence, Sell-Assessment and Self-Awareness which recognizes physicians’ ethical responsibility to provide competent care is fluid and context-dependent at different phases of their careers.
  • Support of free public sunscreen programs.
  • Support of research, stronger public health messaging, and development of resources pertaining to the impact and use of cannabis and cannabinoids, including the creation of an AMA cannabis task force.
  • Directive to develop model state legislation regarding Co-Pay Accumulators for all pharmaceuticals, biologics, medical devices, and medical equipment in order protect patients from out-of-pocket costs.
  • Oppose efforts by organizations to board certify non-physician clinicians in a manner that misleads the public to believe such board certification is equivalent to medical specialty board certification or that is likely to confuse the public about the unique credentials of medical specialty board certification.
  • Adoption of the Council on Medical Services Reports 3 and 4, which address the need for better risk adjustment under alternative payment models and the burden of high and escalating prescription drug prices, respectively.

More highlights from the meeting is available here>>