The American Medical Association’s House of Delegates (HOD), the legislative and policy-making body of the American Medical Association, recently held their annual meeting in June. ASE is proud to be the voice of echocardiography within the HOD. Drs. Peter Rahko and Kameswari Maganti from the Advocacy Committee represent the ASE on the HOD.
While there were no echocardiography resolutions considered during this meeting, there were a broad range of issues discussed that impact many of us. A few that may be of particular interest to you included diversity, prior authorization, and telehealth.
The HOD adopted a n ew policy aimed at increasing diversity in the physician workforce. One of the ways the AMA will accomplish this is through the publication of a white paper chronicling these programs, which will focus not only on helping identify best practices, but also tracking participant outcomes.
The HOD worked to make peer-to-peer prior authorization (PA) talks more effective. PA, all too often, controls access to certain treatments in a bid to cut healthcare spending and peer-to-peer (P2P) discussions, another barrier to care. To help ensure access to care the HOD adopted a policy:
- That P2P prior authorization determinations must be made and actionable at the end of the P2P discussion notwithstanding mitigating circumstances, which would allow for a determination within 24 hours of that discussion.
- That the reviewing P2P physician must have the clinical expertise to treat the medical condition or disease under review and have knowledge of the current, evidence-based clinical guidelines, and novel treatments.
- That P2P prior authorization reviewers follow evidence-based guidelines consistent with national medical specialty society guidelines where available and applicable.
- That reduces the overall volume of health plans’ PA requirements and urges temporary suspension of all prior authorization requirements and the extension of existing approvals during a declared public health emergency.
- That health plans must undertake every effort to accommodate the physician’s schedule when requiring P2P prior authorization conversations.
- That health plans must not require PA on any medically necessary surgical or other invasive procedure related or incidental to the original procedure if it is furnished during the course of an operation or procedure that was already approved or did not require PA.
During the COVD-19 pandemic, telehealth has made healthcare more accessible to patients. This has enhanced patient engagement with remote monitoring, refined clinical workflows and increased practice efficiency and revenue, reduced patient costs, and improved overall healthcare quality. The HOD also adopted a policy addressing c ritical issues related to health inequity, state medical licensure requirements, regulation, and payment.
ASE is proud to be echo’s voice within the HOD. We can only do this with your help. ASE will undergo its five-year review soon, and our representation is dependent on the number of ASE members who also have membership with the AMA. If you are not a member, please consider joining the AMA at that time. Here is the link to the AMA.