Endocrine Insider
June 28, 2007

The Endocrine Society, working with the American Association of Clinical Endocrinologists and the American Society for Reproductive Medicine, co-sponsored a resolution at the June meeting of the American Medical Association (AMA) House of Delegates (HOD). The resolution calling for changes to the Medicare Part D drug program was accepted by the HOD and is now AMA policy. Specifically, the delegates voted that the AMA work a) to eliminate prior authorizations under the program which undermine the ability of the physician to make appropriate medical decisions for their patients, b) with CMS to enforce the statute that requires that all Part D plans include two drugs proven to be equally effective in each therapeutic category, c) with CMS to place reasonable co-pays in the Part D program, d) to develop a one page form for physicians and patients to use to appeal a prescription coverage denial, and e) with interested parties to allow physicians to write a diagnosis on the prescribing form and have it be accepted without question. Discussion on the resolution in the House was largely positive as many felt that the actions requested would help to minimize administrative burdens placed on prescribing physicians.

Significant time was spent discussing the appropriate role of the AMA in developing pay-for-performance (P4P) programs, on either the state or federal level. While almost all participants were strongly against any type of payment tied to quality, opinions differed on whether the AMA should actively oppose the implementation of any P4P program or whether it should participate in the development of such a program in order to have input. Although the HOD made a number of amendments to the Board of Trustees report that will guide the AMA’s approach to future P4P programs, the delegates supported the notion that the AMA’s Principles and Guidelines for Pay-for-Performance should be reaffirmed and that the AMA should oppose the use of tiered and narrow physician networks that deny patients access to, or attempt to steer patients towards, certain physicians primarily based on cost-of-care factors.

Additional resolutions presented at the HOD meeting focused on obesity prevention and graduate medical education (GME) funding. Although the final actions of the HOD on either issue were not known at the time of printing, the reviewing reference committee recommended that the AMA actively collaborate with relevant organizations to ensure the preservation, stability, and expansion of full funding for the direct and indirect costs of GME positions from all sources, including Medicare, Medicaid, Veterans Administration Hospital, the Centers for Disease Control and Prevention, and others. A number of resolutions considered by the HOD called on the AMA to address the obesity epidemic by providing incentives for healthy lifestyles, evaluating the relative merits of bariatric surgery; providing vegetables, fruits, legumes, grains, vegetarian foods and healthful non-diary foods in school lunches; and recommending that nutrition information in fast-food and other chain restaurants include calorie, fat, saturated fat, trans fat, and sodium content information on printed menus and menu boards.