2021 Special Meeting of the AMA House of Delegates - Day 1 Overview

By Policy and Advocacy Brief posted 11-13-2021 20:38


DAY 1 Blog (Saturday, November 13)

AUA Delegates, Drs. Terry Grimm and Hans Arora; Alternate Delegates, Drs. James Gilbaugh and Jason Jameson; Young Physician Section Delegate, Dr. Clint Cary; and Resident/Fellow Section Delegate, Dr. Ruchika Talwar joined hundreds of physicians at the American Medical Association (AMA) House of Delegates (HoD) 2021 Interim Meeting (virtual) to consider resolutions and reports covering clinical practice, payment, medical education, and public health topics. Top issues include urging Congress to stave off impending Medicare payment cuts and debating whether or not to support Medicare drug price negotiation authority.

Last weekend (November 7), AUA delegates participated in a variety of specialty caucus pre-meetings, including those hosted by the Surgical Caucus (organized by the American College of Surgeons), Cancer Caucus (organized by the American Society of Clinical Oncology), and the Specialty and Service Society Caucus meeting.

Following Friday night's opening session, which officially kicked-off the AMA HoD Interim Meeting, they participated in multiple reference committee meetings covering a total of 66 different reports and resolutions. On Saturday, the AUA delegation attended six reference committee hearings and weighed-in on numerous measures including  in Reference Committee A (Medical Service), to which the AUA testified in support of amending Virginia’s Resolution 101 Standardized Coding for Telehealth Services, to advocate by regulation and/or legislation that telehealth services are uniformly identified by using place of service without any additional requirements, such as modifiers imposed by third party payors, for claim submission and reimbursement. The AUA continues to support the full expansion of telehealth services, post the current public health emergency, including adoption of audio-only visits. Join the Discussion at Urology Place.

In Reference Committee B (Legislation), Dr. Arora testified on the following resolutions:

  •  AMA Board of Trustees Report 14 Net Neutrality and Public Health (opposed) examines the effects of Net Neutrality on Public Health and its potential impact on telehealth services. The AUA disagreed with the report findings that net neutrality prevents the growth of broadband infrastructure, specifically touching on telemedicine services. “If the private sector won’t expand broadband infrastructure because of net neutrality the government could expand it as a public utility, particularly in those places the private sector did not. Further, the harms to telemedicine patients from a lack of net neutrality is obvious as providers of telemedicine services will have to "pay to play" to continue to provide services once throttling of broadband is underway and those increased costs will either be passed on to patients, providers or both or result in a drop in access to those services” Dr. Arora said.
  • Resolution 212 Sequestration introduced by the American Society for Clinical Oncology and the American College of Rheumatology; Resolution 221 Promoting Sustainability in Medicare Physician Payments introduced by Texas; and Resolution 224 Improve Physician Payments and Resolution 225 End Budget Neutrality introduced by Florida deal with urgent advocacy efforts needed to oppose various impending Medicare physician payment cuts set to take effect on January 1. Dr. Arora submitted written testimony on behalf of the AUA in support of the measures, stating: “We are one of many organizations who have a strong history of opposing cuts that would strain our ability to keep our practices open. If we can’t keep our practices running, we can’t provide care to our patients. Particularly in the midst of this COVID pandemic our practices could hardly be considered to have recovered to pre-pandemic levels. These resolutions are consistent with one of the AMA’s key strategic priorities, promoting and preserving practice sustainability, a strategic priority which has become even more important during the pandemic.”
  • Resolution 226 Address Adolescent Telehealth Confidentiality Concerns (supported), introduced by Michigan, amends existing AMA policy on Confidential Health Services to encourage physicians in a telehealth setting to offer a separate examination and counseling apart from others and to ensure that the adolescent is in a private space. Dr. Arora said, “As a pediatric urologist offering telehealth services, this is part and parcel to my every day practice. We already do this for the in-person examination; it’s akin to asking a parent to step outside or pulling the privacy curtain, and is a natural extension of maintaining the privacy and confidentiality of some of our most vulnerable patients in the era of digital health.”

On Sunday, AUA delegates will continue their work deliberating reports and resolutions within reference committee meetings covering Science & Technology and Medical Practice.