Huge House win puts telehealth extension in Senate’s hands

The House of Representatives voted overwhelmingly for a bipartisan bill that extends Medicare telehealth payment and regulatory flexibilities through the end of 2024. The House’s 416–12 vote last week is a manifestation of the massive support among lawmakers, patients and physicians to build on the gains of telehealth seen during the COVID-19 pandemic and ensure it continues to be an accessible mode of care for the long haul.

My latest for the AMA. Read the whole shebang.

Also, check out these two recent stories on congressional bills to rein in prior authorization:

Supreme Court curbs EPA’s ability to cut greenhouse-gas emissions

In the third major high-court decision in the last two weeks to deal a blow to public health, a 6–3 U.S. Supreme Court majority restricted the ability of the Environmental Protection Agency to effectively regulate the greenhouse-gas emissions that cause climate change and have been proven to harm the public health.

“Regulating and reducing greenhouse-gas emissions is critical for combating the climate crisis and its major health implications, impacting the respiratory, cardiovascular and immune systems of the U.S. population,” said AMA President Jack Resneck Jr., MD.

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Doctors back continued nationwide access to medication abortion

At the urging of the AMA and the American College of Obstetricians and Gynecologists, the Biden administration announced that it will take steps to protect patients’ access to mifepristone.

“Some states are saying that they’ll try to ban or severely restrict access to” mifepristone and other medications, President Joe Biden said in response to the Supreme Court’s 6–3 ruling in Dobbs v. Jackson Women’s Health Organization that overturned the decades-old Roe v. Wade precedent guaranteeing abortion rights nationwide.

“The American Medical Association and the American College of Obstetricians and Gynecologists wrote to me and Vice President Harris stressing that these laws are not based on evidence and asking us to act to protect access to care,” the president added. “They say by limiting access to these medicines, maternal mortality will climb in America.”

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ICYMI: 10 stories to read from the 2022 AMA Annual Meeting

Nearly 700 physicians, residents and medical students gathered in Chicago for the 2022 AMA Annual Meeting to consider a wide array of proposals to help fulfill the AMA’s core mission of promoting medicine and improving public health.

The occasion marked the first time that the AMA House of Delegates met in person since the emergence of COVID-19, and the physicians did so following a strict health-and-safety protocol. 

My latest for the AMA. The whole shebang.

For a more complete rundown, check out the Highlights from the 2022 AMA Annual Meeting.

Also published recently:

The meeting also was the stage for the full unveiling of the AMA Recovery Plan for America’s Physicians.

10 principles to fix Medicare’s unsustainable physician pay system

The AMA and 120 state medical and national specialty societies have endorsed a set of 10 principles that should guide Congress as lawmakers ponder a much-needed overhaul to remedy the financial instabilities that are affecting physician practices due to the pandemic, statutory payment cuts, lack of inflationary updates and significant administrative burdens.

Under the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, physicians are in the middle of a six-year payment freeze. Adjusted for inflation in practice costs, Medicare physician payment fell 20% from 2001 to 2021, and without an inflation-based update, the gap between frozen physician payment rates and rising inflation in medical practice costs will widen. The Medicare payment system is on an unsustainable path threatening patient access to physicians.

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How Medicare Advantage plans wrongly deny prior auth requests

Momentum to fix prior authorization is building in the wake of a Department of Health and Human Services Office of Inspector General report showing that Medicare Advantage plans delayed and denied patients’ access to medically necessary treatment. They also denied payments to physicians and other health professionals for services that met both coverage and billing rules.

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Why leaked abortion opinion is “antithetical to public health”

In light of a leaked draft Supreme Court opinion that would overturn the abortion rights protected by Roe v. Wade and other precedents, the AMA is profoundly worried about the impact on reproductive health in the United States if the high court ultimately rules in that fashion.

The AMA is “deeply concerned by the contents and implications of the draft Supreme Court opinion for the Dobbs vs. Jackson Women’s Health Organization case that became public this week,” said AMA President Gerald E. Harmon, MD.

“This opinion would lead to government interference in the patient-physician relationship, dangerous intrusion into the practice of medicine and potentially criminalizing care,” added Dr. Harmon, a family physician in South Carolina.

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7 turning points when the AMA met the moment in medicine

Since its founding in 1847, the AMA has been the physician’s powerful ally in patient care and an unrivaled force that promotes the art and science of medicine and the betterment of public health.

From its pioneering work to protect the public from potentially dangerous treatments, to championing the safety and efficacy of vaccines, to advocating for seat belts to be standard in all American automobiles, the AMA has often been at the forefront of sweeping movements to improve the health of our nation.

To comprehensively detail the AMA’s impact is far beyond the scope of this article, but a selective approach can be revelatory as the organization celebrates its 175th anniversary on May 7. A timeline of key dates in AMA history is one place to start, and you can learn more below about seven other critical junctures—one for roughly every 25 years in the organization’s history—when the AMA rose to meet the moment in medicine.

My latest for the AMA. The whole shebang.

Wisconsin’s Gov. Evers vetoes APRN independent-practice bill

Wisconsin Gov. Tony Evers has vetoed a bill that would have granted advanced practice registered nurses the legal ability to practice independently. The governor’s action was supported by the AMA and the Wisconsin Medical Society.

Senate Bill 394 would have removed physician supervision or collaboration requirements for nurse practitioners, nurse anesthetists and clinical nurse specialists after 3,840 clinical care hours in their respective APRN role with a physician or dentist. For nurse midwives, another type of APRN, the legislation would have removed the collaboration requirement altogether.

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Becerra sees need to end Medicare physician pay “cliffs”

In a positive sign in the long-term project of overhauling the Medicare physician payment system to make it more sustainable for doctors and the nation, Health and Human Services Secretary Xavier Becerra said he is “definitely interested” in examining the feasibility of such reform.

“I’m definitely interested, because I remember those ‘cliffs’ when I was in Congress,” Becerra said in a briefing with a group of health reporters, as quoted in MedPage Today, in reference to his days as a congressman and the annual ritual of voting to avert mandated Medicare physician pay cuts.

“We always had to deal with those, and you’d never want professionals … thinking that there’s another profession for them down the line because they’re just not making ends meet where they are,” Becerra said. “So we’d like to be supportive.”

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How doctors can use No Surprises Act to resolve billing disputes

The AMA has assembled a toolkit to help physicians navigate the new independent-dispute resolution process under the No Surprises Act.

The new federal law, which took effect in January of this year, bars surprise billing for emergency care and some nonemergency care at in-network facilities. The law and implementing regulations have established a process to determine payment for physicians, health care organizations and others that includes the IDR process.

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Cardiovascular disease epidemiologist named JAMA’s new top editor

Kirsten Bibbins-Domingo, MD, PhD, MAS, still recalls the excitement she felt early in her career upon learning that her study had been accepted for publication in JAMA.

For the prospective cohort study about NT-proBNP testing and cardiovascular disease events, she remembers “the editor in charge of the paper at the time demanding quite a number of additional analyses and revisions, many more than the reviewers had actually asked for and—finally—saying to us, ‘It’s really important we get things right. Because when JAMA publishes something, it affects clinical practice.’”

Now Dr. Bibbins-Domingo, who has had dozens of articles published in JAMA Network journals and well over 300 altogether, will feel that special obligation on the other side of the desk in medical journalism. Starting July 1, the general internist, cardiovascular disease epidemiologist and national leader in the fields of disease prevention and health equity will become the editor-in-chief of JAMA and JAMA Network.

With each succeeding JAMA Network publication, Dr. Bibbins-Domingo has “seen firsthand how practice or policy has shifted as a result, not just because of the scientific finding, but because of its publication under the trusted name that JAMA represents,” she said during a news briefing this week. “It’s truly very special and I’m thrilled to now be part of it.”

My latest for the AMA. The whole shebang.