The American Medical Association’s (AMA) House of Delegates tackled a diverse set of resolutions this year that are of interest to California physicians, including medical-only exemptions from school vaccination requirements, electronic health record (EHR) meaningful use, ICD-10 implementation, Medicaid rates and opioid abuse.
Given the high level of interest in California’s Senate Bill 277 (Pan), which would eliminate the personal belief exemption for school vaccination requirements in California, AMA adopted a policy calling for immunization for all, and only allowing exemptions where medical reasons contraindicate vaccination.
Several other vaccine-related resolutions were also passed, including supporting parents who want to help educate and encourage their peers to vaccinate [based on a California Medical Association (CMA) resolution adopted during the House of Delegates]; disseminating materials about the effectiveness of vaccines to states; encouraging states to eliminate philosophical and religious exemptions from state immunization requirements; and recommending that states have an “established decision mechanism that involves public health physicians to determine which vaccines will be mandatory for admission to schools.”
AMA also adopted several Medicare-related resolutions on controversial issues. The AMA House overwhelmingly supported a two-year grace period from penalties and recovery audit contractor audits during the ICD-10 implementation, and to make advance payments available if claims are delayed. Resolution 211 calls upon AMA to work with the Centers for Medicare and Medicaid Services (CMS) to give physicians partial credit for accomplishing objectives in the EHR Meaningful Use program, to engage with EHR vendors to reduce the negative effects on physicians, and for AMA to develop a model EHR vendor contract that protects physicians in the event of downtime due to vendor error and other technical problems.
The California delegation presented a number of important resolutions that were adopted as policy, including:
Interest on Medicare Overpayments and Underpayments (Res. 404): That AMA support amending federal Medicare law to require that interest on both overpayments and underpayments to providers attaches upon notice of the error to the appropriate party in either instance.
Reimbursement for End-of-Life Counseling (Res. 402): That AMA advocate for public and private health care insurers to be required to cover counseling for end-of-life care planning as an accepted and integral part of good medical care. The resolution stemmed out of SFMS’ continual advocacy on palliative and end-of-life care.
Study the Impact of the Affordable Care Act (ACA) Medicaid Expansion (Res. 116): Asks that AMA use all available data to study the issues surrounding the ACA expansion of Medicaid to tens of millions of low-income adults to evaluate access, quality of care, adequacy of provider reimbursement and the impact of the ACA on the health care system as a whole.
Electronic Cigarettes (Res. 101): Asks that AMA support a ban on the advertising of electronic cigarettes; hold a position that e-cigarettes should be regulated at the federal, state and local level, consistent with other tobacco products; support education of the public on the known and potential health impacts of electronic cigarettes; and support the taxation of electronic cigarettes to fund research into these products. SFMS’ delegation submitted this resolution at the 2014 CMA House of Delegates and led the campaign for its adoption as CMA policy.