Advocacy Update

May 18, 2017: National Advocacy Update


On May 15, the AMA sent a letter to the Senate leadership reaffirming the principles that should guide consideration of any changes to the Affordable Care Act (ACA). The letter acknowledges that there are problems that need to be fixed. However, the AMA does not support changes to the health care system that would result in affordable health care coverage being beyond the reach of those who are currently covered, that would weaken the health care safety net, or that would compromise the ability of physicians to provide care for their patients.

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Specifically, the letter calls for legislative proposals that would maintain key insurance market reforms—such as coverage for pre-existing conditions, guaranteed issue and parental coverage for young adults—as well as strengthen the individual insurance market. It also advocates adequate support for Medicaid, the Children's Health Insurance Program and other safety-net programs. Further, the AMA calls for reducing regulatory burdens that detract from patient care and increase costs, and for providing greater cost transparency throughout the health care system.

Following House passage of the American Health Care Act (AHCA), Senate Republicans have begun to work on developing alternative proposals that address issues several of their members have raised with the AHCA. It is unclear at this time when a new or revised legislative proposal will be released and considered in the Senate.

The United States Computer Emergency Readiness Team (US-CERT) has received multiple reports of " "WannaCry" (also known as "WannaCrypt") ransomware infections in several countries around the world and in the United States. Some of these infections are having an impact on patient access to care.

On May 15, the AMA emailed the Federation of Medicine with information about ransomware, as well as the steps that physicians should take to guard against WannaCry infection. Anyone who has been affected by the WannaCry infection or did not receive the AMA's email on the topic is encouraged to email Terri Marchiori.

In addition to the information provided in the email, the AMA has resources to help physicians conduct a checkup of their systems, and to secure their networks and office computers. Additionally, the AMA has been engaged with the administration since the cyberattack and will continue to monitor the situation to update its members as more information becomes available.

Participants in a two-day public workshop convened by the Food and Drug Administration (FDA), including AMA Board Chair Patrice A. Harris, MD, MA, urged the government to help facilitate more comprehensive treatment of pain and substance-use disorders, and not expect a short course on safe prescribing to serve as a meaningful solution to the growing epidemic of overdose deaths.

Dr. Harris cautioned that a mandated federal education program could be a check-the-box compliance exercise that would have little impact on patient care. Participants described academic detailing, mentorship and programs that encourage use of multiple modalities to treat pain in a patient-centered manner, not just pharmaceutical options, as necessary to help end the epidemic.

Some participants called for major change in the way the medical profession views pain so that it is not just considered as a symptom of another condition that will go away when the other condition is treated, but instead approached as a condition itself for which a treatment plan is needed. Other federal agencies also described their successful strategies, including the CMS Opioid Overutilization Monitoring System. That system helps physicians coordinate care for their patients with Medicare Part D by informing them when their patients are receiving opioid prescriptions from multiple physicians and pharmacies. The FDA is seeking comments on the topics discussed at the workshop through July 10.