The American Medical Association (AMA) held its Annual House of Delegates (HOD) meeting this June in Chicago. Highlights include:
Medicare Practice Expenses
The AANS/Congress of Neurological Surgeons (CNS) and more than 40 other medical organizations are seeking legislation to halt the Medicare practice expense payment reductions at the current 2000 levels. If enacted, this legislation will give neurosurgeons an additional $130 million in Medicare reimbursement alone from 2001-2005. Key to our success, however, is securing the AMA endorsement of our proposal. To accomplish this, we introduced a resolution for HOD consideration. Although the issue was highly divisive in that it once again pitted specialists against primary care physicians, Neurosurgery’s delegates, particularly Cal Kam, MD, Phil Tally, MD, Troy Tippett, MD and Mark Kubala, MD, were instrumental in getting the HOD to overwhelmingly adopt our “Halt 2000” practice expense proposal. Katie Orrico, director of the AANS/CNS Washington Office, also played a key role, helping build a formidable coalition with other specialties and helping convince primary care physicians they would benefit by increasing reimbursement for practice expenses.
This effort again demonstrated that small specialties like neurosurgery can indeed influence AMA policy if we are highly organized and collaborate with other specialties in the process. The final language of the resolution that passed was:
“RESOLVED, 1) That our AMA seek Congressional action if sufficient funding can be obtained through the current budget surplus to increase the money allocated to the Medicare Physician Fee Schedule, for the purpose of seeking a halt to the amendments of the practice expense provisions of the Medicare law at the 2000 level (50% 1998 PE RVUs blended with 50% proposed 2002 PE RVUs), except for the office visit and office consultation codes, which would continue to increase to their projected 2002 levels, and 2) if sufficient funding cannot be obtained that our AMA continue to support the transition of Medicare practice expenses.”
Legislative Reform of HCFA
Led by Troy Tippett, MD, and the Florida delegation, the HOD adopted a resolution that requires the AMA to “seek immediate and periodic Congressional oversight hearings of the Health Care Financing Administration (HCFA) on issues related to the administration of the Medicare and Medicaid programs and additionally to seek legislation to reform HCFA.” The final resolution also called on the AMA to undertake action “that would hold state and federal agencies, their contractors, and employees dealing with health care issues to the same level of accountability as are physicians.”
This action was taken as a result of the building frustrations physicians have with HCFA’s voluminous, burdensome and confusing regulations. We have already seen results from this action, as the House Commerce Health Subcommittee recently convened the first in a series of oversight hearings aimed at reforming and modernizing HCFA. The AANS and CNS are hopeful that these hearings will lead to positive changes at HCFA that will benefit not only neurosurgeons, but our patients as well.
On-Call Physicians and the EMTALA
The HOD considered several measures supported by the AANS and CNS related to the requirements of the Emergency Medical Treatment and Active Labor Act (EMTALA), including strategies for reimbursing on-call physician. Responding to concerns expressed by many physicians on the inappropriate expansion of EMTALA, the HOD adopted the following resolution requiring the AMA to:
Expeditiously identify solutions to the patient care and legal problems created by current EMTALA rules and regulations; Urgently seek return to the original congressional intent of EMTALA to prevent hospitals with emergency departments from turning away or transferring patients without health insurance; and Strongly opposed any rregulatory or legislative changes that would further increase liability for failure to comply with ambiguous EMTALA requirements.
Neurosurgeons Urged to Join AMA
The AANS and CNS recently launched a collaborative membership campaign with the AMA. Under this program, the AMA has agreed to give AANS and CNS members a special AMA membership bonus package. This includes free AMA membership for the remainder of 2000, a $100 discount ($320 vs. $420) in dues for 2001, a $100 certificate for products from the AMA catalog, notation on the AMA Physician Select Web site that you belong to the AANS and CNS, subscriptions to JAMA and AM News and other benefits. For more details, call 800-AMA-3211.
Dr. Carmel Announces Candidacy
At the conclusion of the HOD meeting, Peter W. Carmel, MD, CNS Delegate to the AMA, announced his intention to run for a position on the AMA Board of Trustees. The election will occur in June 2001, and if Dr. Carmel’s effort is successful, it would mark the first time in decades that a neurosurgeon would hold a seat on the AMA Board and would give neurosurgery an even stronger position within the AMA.
Mark J. Kubala, MD, is a neurosurgeon in private practice in Beaumont, Texas, and the AANS delegate to the AMA’s House of Delegates.