AMA 2023 Interim: Highlights from Newly Adopted AMA Policies on Legislative Advocacy - Medicare

( The American Medical Association (AMA) House of Delegates, convening for their 2023 Interim Meeting in National Harbor, MD, passed several major policy initiatives related to legislative advocacy that have important implications for the field of urology. Medicare payment reform has been a longstanding priority for organized medicine; recently, a 3.4% cut to Medicare payments was announced for 2024.

To address this urgent situation, the AMA adopted policy entitled “Preventing Imminent Payment Cuts and Ensuring the Sustainability of the Medicare Program.” This policy calls for substantial reforms to the Medicare payment framework to guarantee the financial health of medical practices. Specifically, the policy supports the highest possible yearly increases in Medicare reimbursements, indexed to economic indicators such as the Medical Economic Index or the Consumer Price Index, to ensure that Medicare beneficiaries have continued access to care without medical practices suffering economic hardships due to inadequate payment increments.

Medicare Advantage, or Part C plans, are another major advocacy related priority for physician organizations. Policy adopted entitled “Saving Traditional Medicare” added to the payment reform directives, calling for the AMA to inform the public about the advantages and potential drawbacks of expanding Medicare Part C. Furthermore, it highlighted the need for Traditional Medicare legislative reform and policy adjustments that aim to enhance funding, minimize waste, and advocate for inflation-adjusted payments for clinicians. In addition, the AMA is calling on the Department of Justice to prosecute any fraudulent activities related to Medicare Advantage plan overpayments and pushing for a reform in the CMS risk adjustment methods by introducing a competitive bidding system to replace the current benchmark approach for determining Medicare Advantage bonus payments. Lastly, the AMA formally endorsed the "Save Medicare ACT," which seeks to rebrand Medicare "Advantage" plans to "Alternative Private Health Plans.”

Just as rising prescription drug costs were discussed in the sessions around medical service, practice, and insurance, policy on legislative advocacy also adopted a firm public position against the practice of payors and pharmacy benefit managers redirecting patients to their in-house care teams for medical services and prescription writing. Moreover, the AMA is poised to take swift action, including legal or policy interventions, to identify and implement effective strategies to prevent such entities from steering patients towards their own medical teams for healthcare and medication prescriptions.

Additional policy passed, entitled “Improving PrEP and PEP Access” supports measures that enhance the availability of HIV pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) by fostering collaborative agreements between physicians and pharmacists. These agreements are to be modeled on the AMA's own guidelines for collaborative drug therapy management. The AMA also insists that pharmacies prescribing PrEP/PEP should do so in compliance with the most up-to-date CDC guidelines, ensuring that such prescriptions are integrated into a physician-supervised care team.

Written by: Ruchika Talwar, MD, Urologic Oncology Fellow, Vanderbilt University Medical Center during the 2023 AMA Interim Meeting, Nov 10 to Nov 14