AMA News Room
Nov. 19, 2013
AMA Adopts New Policies at Interim Meeting to Improve Health of Nation
For immediate release:
Nov. 19, 2013
WASHINGTON - The American Medical Association (AMA), the premier national physician organization in the country, gathered physician and medical student leaders representing all aspects of medicine during its Interim Meeting and today voted to adopt new policies on emerging issues in public health and science to help improve the health of the nation.
The AMA's House of Delegates is the policy-making body at the center of American medicine, bringing together an inclusive group of physicians, medical students and residents representing every state and medical field. Delegates work in a democratic process to create a national physician consensus on emerging issues in public health, science, ethics, business and government to continually provide safer, higher quality and more efficient care for patients and communities.
The policies adopted by the House of Delegates today include:
Expanding FDA Authority over Nicotine Delivery Products
The AMA adopted policy advocating for the U.S. Food and Drug Administration (FDA) to extend its tobacco regulations to include all non-pharmaceutical tobacco and nicotine products, including electronic cigarettes (e-cigarettes), pipes, cigars and hookahs. FDA oversight of these products is necessary in order to ensure safety and proper labeling, and to deter adulteration and the sale of tobacco products to minors. AMA's existing policy on e-cigarettes from 2010 recommends that they be classified as drug delivery devices, subject to the same FDA regulations as all other drug delivery devices, and supports prohibiting the sale of e-cigarettes that are not FDA approved.
"This policy recommendation for FDA could help ensure that e-cigarettes and other tobacco products have proper oversight and regulation to limit the detrimental health consequences that come from these products," said AMA Board Member Albert Osbahr III, M.D. "Very little data exists on the safety of these tobacco and nicotine products, and the FDA has warned that they are potentially addicting and contain harmful toxins."
Modern Chemical Controls Policy
The AMA adopted new policy calling on Congress to amend the Toxic Substances Control Act (TSCA) of 1976, the only major environmental law that has never been updated since its adoption. The TSCA does not currently require toxicological testing of chemicals before they are used, and many toxic chemicals are in use today. Dangerous chemicals disproportionately affect vulnerable populations and communities through proximity to industrial production facilities, landfills and contaminated properties. The AMA will work with relevant stakeholders to modernize the TSCA to require chemical manufacturers to provide adequate safety information on all chemicals and give federal regulatory agencies reasonable authority to regulate hazardous chemicals.
"Exposure to toxic chemicals is associated with numerous health issues, including higher rates of cancer, asthma, low birth weight, autoimmune diseases, diabetes and obesity," said AMA Board Member Stephen Permut, M.D, J.D. "Ensuring these substances are safe will help better protect public health and patient safety."
Stricter OSHA Standards for Permissible Exposure to Silica Dust
The AMA adopted policy supporting a proposed rule from the Occupational Safety and Health Administration (OSHA) to establish a stricter permissible exposure limit (PEL) for respirable crystalline silica. Crystalline silica is fine dust that is used as an abrasive blasting agent in industries including mining, sandblasting and construction. Research has shown that exposure to respirable crystalline silica leads to significant respiratory disease, including a progressive and often fatal lung disease known as silicosis. The current OSHA PEL of 100 μg/m3 adjusted for silica content is not protective of worker health, leading to many cases of preventable silicosis and related diseases.
"The current level of silica exposure can impact worker health, and lead to many cases of preventable disease," said AMA Board Member Patrice Harris, M.D. "Supporting the OSHA proposed rule can save lives and significantly cut down on worker illness."
Additional policies adopted today by the House of Delegates that are important to the medical community include:
The AMA adopted policy to study current tools and develop metrics to measure physician satisfaction. Findings from a recent RAND Corporation studysponsored by the AMA show that being able to provide high-quality health care is a primary driver of job satisfaction among physicians, and obstacles to quality patient care are a source of stress for doctors.
"Physicians too often feel disconnected from what really matters -- their patients -- yet it's providing patients with high quality care that drives a physician's professional satisfaction," said AMA President Ardis Dee Hoven, M.D. "A physician's professional satisfaction is important to both increase the quality of care for patients and better recruit and retain physicians in health care today."
AMA Push Against RAC Payment Incentives
The American Medical Association (AMA) will continue to strongly push back on the contingency fee compensation structure that promotes aggressive overreach among Medicare audit contractors. A new directive adopted today at the AMA's policy-making meeting calls for penalizing recovery auditors, also known as recovery audit contractors (RACs), when denials resulting from audits are overturned in favor of physicians.
"RAC determinations are overturned nearly half the time when appealed. An inaccuracy rate approaching 50 percent is inexcusable, and the AMA will work to rein-in a program that is perversely incentivized by bounty hunter payments," said AMA Board Member Mary Anne McCaffree, M.D.
The new policy instructs the AMA to advocate that RACs should reimburse physicians who expend substantial resources to successfully defend against erroneous RAC denials. The AMA will continue to urge the Centers for Medicare and Medicaid Services to ensure that RACs are more careful with initial overpayment determinations by imposing a meaningful financial penalty on RACs who lose on appeal.
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