June 15, 2018

Issue Spotlight

News and views from the 2018 AMA Annual Meeting

The 2018 AMA Annual Meeting was full of discussion on the big topics facing the medical community and the country. U.S. Surgeon General Jerome Adams, MD, a special guest at the meeting, gave a speech encouraging AMA members to lead the nation in a civil discussion on the pressing issues of our day, such as gun violence, substance-use disorder and health equity.

Dr. Adams, an AMA delegate, encouraged physicians to look "upstream for root causes and preventative solutions" to substance-use disorders and other health issues. Noting that he joined the AMA 20 years ago, he said that the experience "lit a fire," helping him to develop into a physician leader.

In that spirit, physicians at the meeting backed common-sense gun safety measures, sought to boost affordability and competition in ACA marketplaces, adopted policy that puts organizational muster behind achieving health equity in the U.S. health system, committed to integrating precision medicine into alternative payment models, and declared that drug shortages are a matter of national security.

Visit the Advocating for Patients and Physicians topic page for more coverage from the Annual Meeting.

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National Update

About AMA's amicus brief to defend patients' ACA coverage

In an AMA Wire® Leadership Viewpoints column, new AMA President Barbara L. McAneny, MD, writes:

"This week, the AMA—along with the American College of Physicians, American Academy of Family Physicians, American Academy of Pediatrics, and the American Academy of Child and Adolescent Psychiatry—filed an amicus brief in response to the court case, Texas v. United States. With this action, the AMA opposes a lawsuit that would undermine the policies supported by our House of Delegates, including expanded health insurance coverage and other important patient protections.

"This lawsuit challenges the constitutionality of the Affordable Care Act (ACA), arguing that Congressional action that reduced the tax on individuals who fail to comply with the individual mandate to purchase insurance voids the law itself. The Trump administration announced that it wouldn't defend the law.

"If the plaintiffs are successful, important patient protections and insurance reforms that are current law would cease to exist. These include:

Read more at AMA Wire.

House, Senate continue consideration of opioid abuse legislation

During the week of June 11, the U.S. House of Representatives passed nearly 40 opioid-related bills. The House is expected to vote on at least 20 additional policies next week, likely packaged into a handful of bills. This concludes a renewed effort by  multiple House Committees to develop additional  policies to address the opioid epidemic.

In the Senate, the Committee on Finance approved the Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018 by a vote of 27-0. The bill constitutes a collection of over 20 individual bills to address opioid abuse disorder which were introduced by members of the committee on a bipartisan basis. The AMA will continue to seek improvements to this bill prior to Senate floor consideration.

It is expected that this bill will be merged into a package of opioid bills that includes bills previously adopted by the Health, Education, Labor, and Pensions (HELP) Committee, the Judiciary Committee, and the Commerce Committee, and debated by the full Senate at a time to be determined. The AMA will remain engaged with members and stakeholders as this issue is debated in the Senate, and later reconciled between the two chambers.     

New Medicare Card: MBI look-up tool available through your MAC

As noted in previous editions of AMA Advocacy Update, the Centers for Medicare & Medicaid Services (CMS) is issuing new Medicare cards to beneficiaries to help reduce patient identity theft. The cards have new Medicare Beneficiary Identifier (MBI) numbers that do not use the beneficiary's social security number.

As a result of AMA advocacy, CMS designed a look-up tool for practices to find a beneficiary's new number if the beneficiary does not bring his or her new card to their appointment. The look-up tool is now ready for use. If you don't already have access, sign up for your Medicare Administrative Contractor's (MAC) secure portal to use the tool.

The tool uses four data elements about the patient to return the MBI if CMS has already mailed the new Medicare card to that patient. Medicare is mailing new cards in phases by geographic location. New cards are currently being mailed to people who:

For more information about the MBI, visit the AMA's New Medicare Card page or read this MLN Matters® Special Edition Article.

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State Update

AMA launches new toolkit to help promote opioid education resources

To further bolster physicians' progress to reverse the nation's opioid epidemic, the AMA recently updated the education and training offerings on the AMA opioid microsite, added a new digital toolkit, and is actively seeking stories from physicians on their education and training efforts.

State and specialty medical societies can help promote their education and training resources designed to help end the nation's opioid epidemic through a new tool available on the AMA opioid microsite. The education digital toolkit has sample graphics, banners, messages for Twitter and Facebook, and other options for medical society use.

This toolkit is designed so that medical societies can highlight the education and training resources  that are specific to the unique state- and practice-specific needs of physicians. There now are more than 400 education and training resources provided by medical societies. . If your medical society has information that would be helpful to include, please contact your state or specialty society to have those resources included on the AMA opioid microsite.

In addition, the AMA wants to hear directly from physicians and medical students how they are responding to the nation's opioid epidemic. These experiences will help inform AMA advocacy in our work on behalf of physicians and patients. Physicians and medical students can share their story here.

Virginia to expand Medicaid to 400,000 low-income individuals 

On June 7, Virginia Governor Ralph Northam signed a new state budget into law that includes Medicaid expansion. Under the new budget, the state will submit a Section 1115 Demonstration waiver in the coming months to implement the program.

Once implemented, approximately 400,000 low-income individuals are expected to become eligible for coverage. With this action, Virginia became the 33rd state to approve Medicaid expansion under the Affordable Care Act. 

Maine court orders implementation of Medicaid expansion ballot initiative 

Last November, Maine became the first state to expand Medicaid through a voter referendum. Voters in Maine overwhelmingly approved the measure with nearly 60 percent of the vote. Gov. Paul LePage refused to implement the program, however, citing budgetary concerns.

On June 4, a state court ordered the government to implement the Medicaid expansion program as approved by the voters. Governor LePage filed an appeal of the ruling on June 7. Approximately 80,000 Mainers are expected to become eligible.

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Judicial Update

Florida case puts medical staff self-governance under fire

After a hospital medical staff renewed a physician's privileges, trustees at the Florida hospital moved to push out the 15-year veteran by refusing the renew his privileges because they claimed their own investigation found deficiencies in his patient care and that he exhibited "disruptive behavior."

The physician sued the hospital, asking that his privileges be renewed because he and the hospital were bound by the medical staff bylaws, under which he was found suitable for recredentialing. The doctor—Anil Desai, MD—also maintains the fair hearing procedure the hospital offered was not contemplated under the medical staff bylaws and he, consequently, was not obligated to accept the hearing.
Now, in a case that will have an impact on medical staff self-governance, the Florida Supreme Court will decide whether the physician has to accept the trustee's hearing. In such a hearing, the physician would have to defend himself against the hospital's claims—claims that medical staff recredentialing committee and the medical executive committee members reconsidered after the hospital's accusations and found them factually unconvincing. 

The Litigation Center of the American Medical Association and State Medical Societies in March joined with the Florida Medical Association in filing a friend-of-the-court brief with the state's high court in the case, Desai v. Lawnwood Medical Center. The Litigation Center brief argues that Lawnwood Medical Center violated Dr. Desai's contractual rights and Florida law by refusing to renew his staff privileges without following the peer-review procedures outlined in the medical staff bylaws.

Read more at AMA Wire.

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Other News

Now available for CME: electronic prior authorization videos

The AMA's three-part educational video series on pharmacy electronic prior authorization, "Electronic Prior Authorization: A Better Way," has been approved for AMA PRA Category 1 Credit™ and is worth 0.25 credits.

The videos demonstrate the workflow improvements and other advantages of implementing pharmacy electronic prior authorization transactions that integrate with electronic health record systems and offer tips on how practices can start using this technology. To register for this activity, visit the AMA Education Center.

Reach MD podcast episode 2 now available

The second in a series of six podcasts produced in partnership with Reach MD is now available. The episode is an interview with lobbyist Laura Hoffman and Senior Health IT Consultant Matt Reid on Things to consider if you're filing for an ACI Hardship Exemption and transitioning from 2014 to 2015 edition CEHRT. Listen here

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Upcoming Events

June 20: Health literacy solutions
There is a growing need to understand the socioeconomic issues surrounding patients and the lack of resources and assets on the topic of health literacy. In this AMA webinar, Dr. Mary Reeves, TCPI National Faculty, as well as several team members from HealthCare Dynamics International, will define health literacy and how it can have an impact on reporting and your practice overall, as well as discuss tools and resources that address clinician concerns regarding the social factors affecting their patient population and the impact of these factors on clinical outcomes. Register.

July 25: EHRs—Usability and optimization
Electronic health records have transformed health care over the last decade. While they have improved some aspects of clinical practice, they are still often associated with physician burnout and patient safety concerns. This webinar, noon–1 p.m. CDT—will provide an overview of the AMA's initiatives focused on improving the usability of EHRs through research, guiding principles and collaboration. It will also cover resources and best practices available to physicians and practices to support optimization. Register.

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