Highlights from the 2026 AMA Annual Meeting
Earlier this week, the House of Medicine concluded its 2026 AMA Annual Meeting, where hundreds of physician and medical student delegates debated and set policy for the organization. For a full listing of the proceedings, visit the AMA website.
“Throughout its history, the AMA has led by defining what better medicine should look like,” said AMA CEO John Whyte, MD, MPH, in remarks delivered to the House of Delegates. “A system grounded in science. In ethics. In innovation. And above all, in trust. That responsibility now belongs to us—not simply because medicine is changing, but because we can still shape what it becomes.”
“We are living through a defining moment in American healthcare, one that demands leadership grounded both in clinical experience and in a commitment to equity,” said AMA President Willie Underwood III, MD, MSc, MPH, in his inaugural address. “As president, I will focus on bringing physicians together to close the gaps in access, outcomes and opportunity so that every patient, in every community, receives the care they deserve. We must build a system that works, not only for some of us, but for the sum of us.”
Key issues discussed at the meeting include:
Medicaid work requirements: Delegates adopted new policy urging federal and state policymakers to ensure that Medicaid work requirements are implemented in a manner that protects patients with serious medical needs while minimizing administrative burdens on patients and physicians.
Medicare payment reform: Delegates emphasized the need for the AMA to remain committed to reforming the Medicare physician payment system.
Augmented intelligence: Delegates adopted new policies to ensure AI strengthens patient care, supports evidence-based medicine, and remains under the oversight of physicians rather than replacing physician judgment.
Prior authorization: With physicians and patients continuing to encounter time wasting, clinically dangerous prior authorization roadblocks despite insurer pledges to fix the broken system, delegates voted to take more steps to hold companies responsible and get patients the care they need.
Scope of practice: Delegates acted to eliminate the confusion around who is a physician—and thereby boost patient safety—by deliberately avoiding use of the term “provider” when referring to any clinician with a medical degree.
Physician burnout: The House of Delegates took steps to build on previous efforts to support reducing system-level drivers of burnout, ensure a safe workplace, and promote flexibility and autonomy in practice conditions.
Corporate practice of medicine: Delegates adopted a sweeping policy refining the organization's longstanding opposition to the corporate practice of medicine, intending to protect physician autonomy and patient care from corporate influence.
For more information, view the complete day-to-day overview of meeting highlights.
CMS publishes Medicaid work requirement rules that limit exemptions for people with serious medical conditions
On June 1, the Centers for Medicare & Medicaid Services (CMS) published an interim final rule (IFR) implementing Medicaid work and community engagement requirements outlined in Public Law 119-21, also known as the “One Big Beautiful Bill Act” (OBBBA).
Signed into law on July 4, 2025, the OBBBA established mandatory Medicaid community engagement requirements—commonly referred to as work requirements—for expansion population adults ages 19 to 64, excluding those who are pregnant, enrolled in Medicare, or in other mandatory Medicaid groups. To remain eligible, affected individuals must typically engage in 80 hours of work or related activities per month, enroll at least half-time in educational programs, or meet specified income thresholds, with verification of compliance required at least once every six months. The law outlines several exemptions, including for individuals considered medically frail—those who are blind, disabled, or have a substance use disorder, disabling mental disorder, significant physical, intellectual, or developmental disability, or serious or complex medical condition.
The IFR narrows the definition of medical frailty by requiring that an individual’s condition significantly impairs their ability to comply with work requirements, in addition to falling into one of the OBBBA’s five categories of medical frailty. This restrictive definition will limit access to exemptions, even for individuals with serious medical conditions, and increase administrative burden on physicians and other safety net providers. Additionally, the regulations require states to reverify medical frailty exemptions every 12 months, creating ongoing administrative burden for individuals with long-term or permanent conditions. The rules permit states to accept self-attestations of medical frailty in 2027, though states may choose to require documentation. Beginning in 2028, states may accept self-attestations for new enrollees but must verify medical frailty at the individuals’ next eligibility redetermination, typically after six months. CMS predicts that 15% of Medicaid enrollees subject to the work requirements will lose coverage.
The AMA opposes work requirements as a condition of Medicaid eligibility and has been a strong advocate for protecting Medicaid access and minimizing administrative obstacles for both patients and providers. In a March 9 letter (PDF) to CMS, the AMA urged clear definitions of medical frailty and warned against approaches that could create undue hardship and barriers to care for vulnerable populations. The AMA also met with senior CMS officials to discuss and reinforce our points on medical frailty and self-attestation. Those discussions were positive, so it was dismaying to hear reports in mid-May that the administration was backtracking on its original plan for medical frailty policies. Within a day of these troubling reports, the AMA sent a letter (PDF) to CMS Administrator Oz emphasizing the need for reasonable medical frailty exemptions and cautioning about increased documentation demands. The AMA also raised strong concerns to senior HHS and CMS officials. To further support physicians and federation partners, the AMA has published advocacy resources on medical frailty exemptions (PDF) and short-term hardship exemptions (PDF), which explain policy details and identify advocacy opportunities as states work to implement these requirements.
Most recently, the AMA released a patient guide (PDF) designed to help Medicaid enrollees understand work requirements, exemption criteria, and steps to protect their coverage. Physician practices are encouraged to share this resource broadly.
Prior authorization reform bill introduced in the House
The AMA’s multi-pronged federal effort to reform different aspects of prior authorization took another step forward following the introduction of H.R. 9192, the “Prior Authorization Reform for Autoimmune and Blood Disorders Act.” Sponsored by Reps. Jule Johnson (D-TX) and Mike Lawler (R-NY), this bipartisan legislation would limit the number of prior authorizations required by private health insurance plans, including self-insured plans governed by the Employee Retirement Income Security Act (ERISA), to once per year for drugs for patients with autoimmune diseases or blood disorders.
In a June 9 letter (PDF) to the lead bill sponsors, the AMA’s CEO and Executive Vice President, John Whyte, MD, MPH, wrote that:
“The ‘Prior Authorization Reform for Autoimmune and Blood Disorders Act’ preserves prior authorization as a utilization management tool for [health] plans while limiting its repeated application where the underlying clinical picture has not changed. The legislation includes narrow, clinically appropriate exceptions for drugs typically used for less than a year, for opioids and certain other controlled substances, and for drugs subject to a Risk Evaluation and Mitigation Strategy under federal law. These exceptions preserve plan flexibility where it is justified by clinical or safety concerns without weakening the bill’s core protection for patients on chronic therapy.”
The provisions in this bill are very similar to those included in H.R. 5467, the Patient Access to Autoimmune Treatments (PAAT) Act, which was introduced by Reps. Johnson and Mike Kennedy, MD (R-UT), in Sept. 2025. While H.R. 5467 also prevents repeat prior authorization reviews for drugs for autoimmune and blood disorders, the bill is restricted to Medicare Advantage prescription drug plans and stand-alone Medicare Part D plans. H.R. 9192 concentrates on utilization management techniques for drugs treating these conditions in the private health insurance market, including self-insured ERISA plans. The AMA sent a separate letter of support (PDF) for the PAAT Act in September 2025.
In a joint press release issued by both Reps. Johnson and Lawler, AMA Immediate Past President Bobby Mukkamala, MD, is quoted as saying:
“Prior authorization, especially repeat requests, contributes significantly to physician burnout and, more importantly, jeopardizes patients’ timely access to care. An American Medical Association survey found that 95% of physicians report prior authorization requirements delay necessary treatment. Additionally, 79% of the survey respondents said prior authorization can at least sometimes result in patients abandoning recommended treatment altogether. Given these alarming findings, the AMA commends Reps. Julie Johnson (D-TX) and Mike Lawler (R-NY) for introducing the Prior Authorization Reform for Autoimmune and Blood Disorders Act to ensure the commercial market does not inappropriately use utilization management techniques for these two important areas of patient care.”
H.R. 9192 is also endorsed by the Texas Medical Association, the Autoimmune Association, the American Society for Gastrointestinal Endoscopy, and the North American Society for Pediatric Gastroenterology-Hepatology and Nutrition.
CMS offers dedicated physician resources on the ACCESS model
Starting in July, the CMS Innovation Center’s Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) model will test expanded provision of digital health tools to help manage prevalent chronic conditions for patients with traditional Medicare coverage. Organizations participating in ACCESS will provide technology-based services to Medicare patients with hypertension, prediabetes, chronic kidney disease, musculoskeletal pain, depression and other chronic conditions.
ACCESS organizations will receive modest monthly payments linked to improvements in specific patient health outcomes for these chronic conditions. Although each organization must have a physician clinical director, the only Medicare payments they can submit claims for are the ACCESS-specific monthly payments—they cannot submit claims for any individual services like visits, tests, or procedures to Medicare.
The AMA has heard from physicians with questions about the ACCESS model such as how to help their patients choose an ACCESS organization to help with their care, and what data and information they will receive from ACCESS participants about the services their patients are receiving. They also want to know what is expected of physicians who want to bill Medicare for “co-management” payments for physicians whose patients are receiving services from an ACCESS organization.
In response, CMS has developed a dedicated webpage specifically for physicians who have questions about ACCESS and whose patients may enroll with an ACCESS participating organization. According to CMS officials, this new resource is intended to answer many of the questions from physicians that the AMA has shared with the agency. It includes a link to a list of all the organizations accepted to participate in ACCESS and which chronic condition tracks they will offer, as well as how patients will enroll, samples of the information their physicians will receive and how to bill the co-management service.
An introduction to the ACCESS model is available in a podcast interview that AMA CEO John Whyte, MD, MPH, conducted with CMS Deputy Administrator and Innovation Center Director Abe Sutton.
To provide feedback about the new CMS webpage, please contact [email protected].
