SGR, Ebola, MOC, and Unionization Discussed at AMA Interim Meeting

The Michigan Delegation to the American Medical Assocation (AMA) House of Delegates discussed, debated, and acted upon a number of critical health care issues during the AMA Interim meeting on November 7-11 in Dallas.

Some of the topics included SGR repeal, Ebola, meaningful use, maintenance of certification, e-cigarettes, and physician unionization.

Serving at the AMA Interim Meeting from the Michigan Delegation were Betty Chu, MD, MBA, from Oakland County, and Bassam Nasr, MD, MBA, from St. Clair County, both of whom served on the Reference Committee F regarding AMA finances. John Bizon, MD, served as a teller.

Hot topics at the AMA Interim Meeting included the following.

SGR REPEAL: The AMA's lead lobbyist and two U.S. Congressmen told the House of Delegates that repealing and replacing the flawed Sustainable Growth Rate formula in this fall's lame duck session of Congress is the best opportunity for a fix. Texas Congressman Michael Burgess, MD, said "we are in extra innings," but there remains bipartisan, bicameral support to fix the SGR. His fellow Texas Congressman Kevin Brady said the difficulty remains the "pay fors," in other words, what will be cut in the budget to pay for the $150 billion fix. AMA lead lobbyist Richard Deem said Michigan Congressmen Fred Upton and David Camp have pushed the legislation to the point that "we are closer than ever." However, he noted that "legislation is the art of compromise, but this (fix) is a clear improvement over current law." He said a "patch 18" would be unacceptable to the AMA. Contact your legislators to voice your opinions by using the MSMS Action Center under the Advocacy tab at Deem also noted that the AMA will work to repeal the Independent Payment Advisory Board in the next legislative session.

EBOLA: A leading expert on Ebola from the CDC told the House of Delegates in a special educational session that "ultimately, the best way to protect the U.S. is to stop the outbreak in Africa." Details about diagnosing and treating patients as well as protecting health care workers were provided. The House later discussed four resolutions regarding Eloba and combined them into one that called for support of global efforts to fight Ebola and other epidemics and pandemics and to work to ensure that quarantine interventions are based on science and not politics or emotion. The House also committed the AMA to being a trusted source for dissemination about all information regarding Ebola on its Ebola Resource Center at Please visit MSMS' website for the latest Ebola resources and information.

MEANINGFUL USE: A very popular resolution among delegates about electronic health records called for the AMA "to continue to advocate that the Centers for Medicare & Medicaid Services suspend penalties to physicians and health care facilities for failure to meet Meaningful Use criteria." Testimony emphasized the fact that the meaningful use program remains a significant cost and disruption to physicians and that EHRs are not yet capable of exchanging health care information across different systems.

MAINTENANCE OF CERTIFICATION: Four resolutions about various aspects of Maintenance of Certification (MOC) engendered significant, strong discussion in reference committee and on the floor of the House regarding the balance between the costs and burdens of MOC versus maintaining physician competence and public trust. A combined, substitute resolution was adopted that called for the AMA to add a number of amendments to its current Principles on MOC to use when in discussions with the American Board of Medical Specialties including cost, relevance, and design. Also added was that MOC should not be a mandated requirement for licensure, credentialing, reimbursement, network participation, or employment, as well as to eliminate the practice performance assessment modules. The AMA Council on Medical Education will report back to the AMA House of Delegates at the Annual meeting in June 2015.

E-CIGARETTES: Three resolutions were combined with a new report from the AMA Council on Science and Public Health that called on the AMA to support legislation to set 18 as the minimum age for buying and using any e-cigarette product, to prohibit the use in any health care setting, and to apply the same restrictions as those on tobacco for marketing and sales including a prohibition on television advertising.

PHYSICIAN UNIONS: A resolution calling for the AMA to conduct a study about physician unionization was adopted after arguments on both sides of the issue were aired. On the con side, some delegates argued that the only way unions are effective is through work stoppages and that medical ethics outlaws such activity by physicians. On the pro side, the argument was made that the number of employed physicians in all practice settings has increased significantly since the last time the AMA studied this issue in 2001. A new AMA study will be conducted, but a timeframe for reporting back was not immediately set.

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