A bipartisan majority from both chambers of Congress is pressing the Centers for Medicare & Medicaid Services (CMS) to finalize a pending federal regulation that would overhaul prior-authorization requirements within Medicare Advantage.

“We urge CMS to promptly finalize and implement these changes to increase transparency and improve the prior-authorization process for patients, providers and health plans,” wrote the lawmakers. “We are pleased that these proposed rules align with the bipartisan, bicameral Improving Seniors’ Timely Access to Care Act, which proposes a balanced approach to prior authorization in the [Medicare Advantage] program that would remove barriers to patients’ timely access to care and allow providers to spend more time treating patients and less time on paperwork.”

My latest for the AMA. The whole shebang.

As part of its campaign to fix the unsustainable Medicare physician payment system, the AMA is outlining in a quick, easily navigable fashion why doctors’ Medicare payments must be tied to an inflation index called the Medicare Economic Index.

My latest for the AMA. The whole shebang.

The U.S. Supreme Court has issued a decision to restrict public and private higher-education institutions from considering an applicant’s race or ethnicity in admission decisions. The court’s action effectively overturns nearly five decades of precedent allowing for limited use of affirmative action in college admissions. The Supreme Court’s six conservative justices carried the majority in two separate cases involving race-conscious admissions at Harvard University and the University of North Carolina.

The decision “undermines decades of progress centered on the educational value of diversity and will reverse gains made in the battle against health inequities,” said AMA President Jesse M. Ehrenfeld, MD, MPH, who is a senior associate dean, tenured professor of anesthesiology and director of the Advancing a Healthier Wisconsin Endowment at the Medical College of Wisconsin.

The AMA and more than 40 other organizations joined an Association of American Medical Colleges-led amicus brief that urged the high court to “take no action that would disrupt the admissions processes the nation’s health-professional schools have carefully crafted in reliance on this court’s longstanding precedents.”

Dr. Ehrenfeld said the ruling “restricts medical schools from considering race and ethnicity among the multiple factors in admissions policies and will translate into a less diverse physician workforce.”

My latest for the AMA. The whole shebang.

More than 900 health care facilities took active part in the most recent edition of the Human Rights Campaign’s “Healthcare Equality Index,” the country’s foremost benchmarking survey of health care organizations’ policies and practices dedicated to the equitable treatment and inclusion of their LGBTQ+ patients, visitors and employees. …

Nearly 500 facilities earned the Human Rights Campaign’s “LGBTQ+ Healthcare Equality Leader” designation, receiving the maximum score in each section and earning an overall score of 100.

Among them are these members of the AMA Health System Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.

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A bipartisan group of 60 senators has reintroduced the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act. The CONNECT for Health Act, S. 2016, will expand coverage of telehealth services through Medicare, make permanent COVID-19 telehealth flexibilities, improve health outcomes, and make it easier for patients to connect with their doctors.

My latest for the AMA. The whole shebang.

The AMA has been on the road fighting for Medicare physician payment reform for well over a decade, and the system remains on an unsustainable path. Temporary patches and ongoing cuts to the Medicare physician payment system have left physician practices and patient access to care at serious risk.

Payment cuts, freezes and redistributions have further exacerbated the challenge. When adjusted for inflation, Medicare physician payment has effectively declined 26% from 2001 to 2023.

Despite that stark reality, Congress and the administration are still not focused on fixing the root of the problem—the payment system itself. But it’s time for that to change. It’s essential that leaders in Washington work with the physician community on immediate, preventative measures, as well as long-term solutions that will reform the payment model once and for all.

“This cannot wait; we are past the breaking point,” said AMA President Jack Resneck Jr., MD. “Congress must urgently address physician concerns about Medicare to account for inflation and the post-pandemic economic reality facing practices nationwide.”

My latest for the AMA. Read the whole shebang, as reported from the 2023 AMA Annual Meeting this week in Chicago.

Also check out my other coverage of the meeting:

• Highlights from the 2023 AMA Annual Meeting
• ICYMI: 10 stories to read from the 2023 AMA Annual Meeting

The AMA is opposing legislation introduced in the U.S. House of Representatives that would inappropriately allow pharmacists to furnish services that would otherwise be covered if they had been provided by a physician, despite pharmacists not having the same extensive education and training as physicians.

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A majority of U.S. states are considering legislation to rightsize the time-wasting, care-delaying payer practice of prior authorization. In all, nearly 90 prior-authorization reform bills have been considered this legislative session in 30 states, and more than a dozen are still on the table for potential passage.

My latest for the AMA. Read the whole shebang.

A bill has been introduced in Congress to tie the Medicare physician payment schedule to the Medicare Economic Index, a move that is essential to protecting access to high-quality care for the 65 million older adult Americans covered by Medicare.

By instituting an annual inflation-based update, the legislation would put physicians on equal footing with virtually all other health professionals and organizations paid by Medicare. Physician payment rates have been subject to a six-year payment freeze that will last until 2026 and are seeing 2% across-the-board Medicare pay cuts that started in January.

My latest for the AMA. The whole shebang.

While health insurers claim prior-authorization requirements are used for cost and quality control, a vast majority of physicians say authorization protocols lead to unnecessary waste and avoidable patient harm.

One-third of the 1,001 physicians surveyed by the AMA in December reported that prior authorization has led to a serious adverse event for a patient in their care.

More specifically, the AMA survey found that these shares of the physician respondents reported that prior authorization led to:

• A patient’s hospitalization—25%.
• A life-threatening event or one that required intervention to prevent permanent impairment or damage—19%.
• A patient’s disability or permanent bodily damage, congenital anomaly or birth defect, or death—9%.

My latest for the AMA. The whole shebang.

For the first time since the pandemic’s onset, hundreds of physicians, medical society staffers and others met in person in a bitterly divided Washington, D.C., for the AMA National Advocacy Conference.

This year’s legislative and regulatory priorities are crystal clear, driven by the urgent need to protect patients’ access to high-quality care and help physicians who have put so much on the line during the COVID-19 pandemic.

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The AMA and nearly 120 physician organizations are strongly supporting proposed reforms of prior authorization in Medicare Advantage and the Medicare prescription drug benefit.

The physician organizations sent a letter to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure thanking her and urging the agency to finalize proposed reforms that target the inappropriate use of prior-authorization requirements by Medicare Advantage plans to delay, deny and disrupt the provision of medically necessary care to patients.

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Physicians and medical students’ time is more squeezed than ever by the demands of practicing and studying amid the tripledemic and soaring rates of professional burnout. It’s no surprise that a growing number of physicians and future doctors are taking advantage of listening to podcasts to enhance their knowledge of trends in medicine while commuting, running errands, making dinner or doing housework.

In 2022, more than 600,000 episodes of AMA podcasts were downloaded as listeners learned from doctors and other experts who give voice to an array of original AMA podcasts.

My latest for the AMA, which highlights 10 of our most popular episodes in 2022. Read the whole shebang.