November 18, 2024
The 2024 Interim Meeting of the American Medical Association (AMA) House of Delegates covered critical issues affecting the U.S. health-care system. Among the most pressing topics was Medicare physician payment, which remains the AMA's top advocacy priority. The Centers for Medicare & Medicaid Services (CMS) proposed a 2.8% payment cut for the upcoming year, further deepening a 29% decline in Medicare physician payments since 2001 when adjusted for inflation. AMA President Dr. Bruce A. Scott emphasized that these cuts are putting physicians in an impossible position—either turning away patients, reducing hours, or closing practices—ultimately harming the most vulnerable populations, particularly the elderly and disabled.
PALTmed’s resolution, “Expand Access to Skilled Nursing Facility Services for Patients with Opioid Use Disorder,” called for addressing the barriers that individuals with opioid use disorder (OUD) face when seeking care at skilled nursing facilities (SNFs). In lieu of passing the resolution, the AMA House of Delegates (HoD) reaffirmed existing policy (D-95.955) to improve access to post-acute care for patients with substance use disorders (SUD), specifically advocating for the removal of barriers to care for individuals with OUD.
PALTmed Delegates Karl Steinberg, MD, HMDC, CMD, and Leslie Eber, MD, CMD, testified at the meeting to emphasize that a history of OUD or the use of appropriate medications for OUD should not be a barrier to receiving necessary care in SNFs. Denying access to care based solely on an OUD diagnosis, or a patient’s use of medications like methadone or buprenorphine, exacerbates the stigma surrounding addiction and can lead to inadequate care for those in need of physical rehabilitation or other post-acute medical services. The resolution received significant support, getting an endorsement from several key caucuses. The AMA HoD ultimately reaffirmed its existing policy noting the importance of this issue.
Other resolutions and policy updates of importance:
- Prior Authorization: Delegates adopted a policy to prevent insurers from retroactively denying or recouping payments for care that had been precertified, unless there was fraudulent or materially false information provided by the health-care provider.
- Physician-Led Care: A new policy was passed to ensure that physician supervision remains essential in emergency departments, with a particular focus on rural and remote facilities that face unique challenges.
- Telehealth: Delegates modified existing policy to help remove barriers to telehealth adoption and make health IT more accessible. They also reaffirmed the call for permanent Medicare and health insurance reimbursement for telehealth services.
- Augmented Intelligence: A comprehensive set of principles was approved to guide the ethical development and use of augmented intelligence (AI) in health care, ensuring that AI tools enhance, rather than replace, the human touch when caring for patients.