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 AMA Interim Meeting - November 2006

AMA Interim Meeting
November 11-14, 2006

Submitted by Charles Day, MD, MBA
ASSH Delegate to AMA-YPS and AMA-HOD
(Drs. Kessler and Nagle not available)
November 10 - 14, 2006

Resolutions of ASSH interest:

1) Group practice formation by a referring physician – Resolution calls for the AMA to create a policy stating that the formation of a multi-specialty group practice in order to get reimbursed for referrals is unethical.

2) “Conflicts of Interest:  Health Facility Ownership by a Physician” Amendment – Resolution calling on physicians who invest in health care facilities to refer patients only on the basis of medical need, disclose their investment interests to their patients, provide patients with information about alternative facilities, and make arrangement for the care of patients if the conflicts of interest cannot be adequately resolved.

3) Placebo use in Clinical Practice – Resolution from Council on Ethical and Judicial Affairs (CEJA) stating that the AMA recognize that placebo is a substance provided to a patient that the physician believes has no specific pharmacological effect upon the condition being treated.  In the clinical setting, the use of a placebo without the patient’s knowledge may undermine trus, compromise the patient-physician relationship, and result in medical harm to the patient.

4) Industry representatives in clinical settings – Resolution from CEJA stating that physicians must be knowledgeable about the equipment and devices they intend to use in treating patients.   When industry representative are present during a physician-patient encounter, physicians must ensure that the representatives possess the expertise and training, monitor the representatives not to have direct patient contact, disclose their presence to the patient, ensure the representative observe medical standards of privacy, and ensure the representative abide by general safety measures.

5) National Health Care Policy Agenda – Resolution seeking the AMA to advocate a comprehensive, patient-centered mational healthcare policy agenda that takes into account the most important issues affecting physicians and patients including public- and private-sector financing and delivery, wellness and personal responsibility, liability, patient safety, and health information technology.  Moreover,  it authorizes the AMA to convene strategic discussions among the leaders of the United States’ medicine, business, healthcare, employers, and government.

6) Home sedation for children undergoing outpatient procedures – Resolution seeking the AMA to examine the issue of sedating children outside of a monitored healthcare setting and develop a set of comprehensive guidelines on the sedation of children outside of a monitored health care setting.

7) Arbitrary and Abusive Economic Profiling – Resolution that the AMA use all available means at its disposal to oppose and prevent the arbitrary and abusive use of efficiency measures and other forms of economic profiling in Pay-for Performance and public reporting programs.

8) The future of emergency and trauma care – Resolution that the AMA continue a dialogue with relevant specialty societies to gather data and identify best practices for the staffing, delivery and financing of emergency/ trauma services.  It also recommends advocating for insurer payment to physicians who have delivered emergency care, regardless of in-network or out-of-network patient status.

9) Postoperative Care of Surgical patients – Resolution that the AMA continue to strongly encourage the Center for Medicare and Medicaid Services and private payers to recognize CPT codes and their appropriate modifiers to the describe the segment of preoperative, surgical or postoperative, surgical care performed during the global period when more than one physician delivers a specific segment of the care.

10) Need for Active Medical Board Oversightoof Medical Scope of practice Activities by Mid level Practitioners – Resolution that AMA recognize the full authority of state medical boards to regulate the practice of medicine by all persons within a state notwithstanding claims to the contrary by boards of nursing, midlevel practitioners or other entities.

Please feel free to contact me if there are questions:

Charles S. Day, M.D., M.B.A.
Chief, Orthopedic Hand & Upper Extremity Surgery
Assistant Professor in Orthopedic Surgery
Harvard Medical School
Beth Israel Deaconess Medical Center



Submitted by Andrew Gurman, MD - ASSH Delegate to the AMA

The American Medical Association interim meeting was held in Las Vegas, NV, November 11 - 14. Secretary of HHS Michael Leavitt articulated the Bush administration's position that costs need to be controlled, and that quality measures are viewed as the means to do that. View the full article.

Items of interest to the hand surgery community include:
1) A commitment to educate physicians and component societies about administrative and judicial appeals for audits by recovery audit contractors. The litigation center has resources as well.
2) An educational session on repricers and silent PPO's. If you or your group has a contract with any PPO, and you don't know what this is, you need to educate yourself about how your fees may be discounted without your knowledge.
3) Pay for performance guidelines must be voluntary, evidence-based, and not used to decrease payment for services rendered.
4) Statement opposing criminalization of the act of providing medical care to undocumented immigrants.
5) Opposition to economic credentialling.
6) Efforts to repeal the Medicare reimbursement cut.
7) Projected surgeon shortage.
View a detailed list of meeting highlights.

In addition, the AMA's priorities for 2007 remain:
1) Repeal/permanent fix of the SGR
2) Liability reform
3) Access to medical care for all/universal health coverage
4) Lifestyle issues: obesity/smoking
5) P4P