Report from the NC Medical Society’s delegation to the American Medical Association
2024 AMA Interim Meeting / House of Delegates
A key Q4 event each year is the American Medical Association’s annual Interim Meeting. The meeting is the second of the AMA’s semi-annual House of Delegates sessions, which convene delegates from across the country, representatives of specialty societies, and resident and student members. The AMA House of Delegates sets policy and sets healthcare regulation, legislation and education initiatives into motion.
Representing the NC Medical Society at the 2024 AMA Interim Meeting were the following delegation members.
The 2024 AMA Interim Meeting culminated 28 years of service by Dr. Darlyne Menscer as a member of the NCMS delegation to the AMA. She was recognized by the AMA at the 2024 Interim Meeting and also by the NCMS at the 2024 NCMS LEAD Conference when she and Dr. John Fagg were celebrated for their dedicated leadership. Dr. Fagg concluded 25 years on the AMA delegation in 2023.
Among the most pressing topics on the Interim Meeting agenda was Medicare physician payment, which remains a top advocacy priority for the NC Medical Society. Earlier in 2024, the Centers for Medicare & Medicaid Services (CMS) announced a 2.83% physician payment cut for 2025, exacerbating the 29% decline in Medicare physician payment since 2001 when adjusted for inflation. “Fix Medicare Now” was a resounding theme of the meeting. The cut has sadly gone into effect, making the upcoming session of Congress very pivotal for practices and Medicare patient.
The NCMS delegation to the AMA remains involved with House of Delegates activity throughout the year and is extremely engaged at each meeting.
House of Delegates Action
Over the course of several days, the AMA House of Delegates addressed 104 resolutions along with 38 reports from the Board of Trustees and Councils. The following is an abbreviated list of the House’s actions with excerpts from the items adopted.
ED Care – Physician Presence
RESOLVED, That our American Medical Association recognize that the preferred model of emergency care is the on-site presence of a physician in the emergency department (ED) whose primary duty is to provide care in that ED, and support state and federal legislation or regulation requiring that a hospital with an ED must have a physician on-site and on duty who is primarily responsible for the emergency department at all times the emergency department is open.
That our AMA, in the pursuit of any legislation or regulation requiring the on-site presence of a physician who is primarily responsible for care in the emergency department (ED), will support state medical associations in developing appropriate rural exceptions to such a requirement if, based on the needs of their states, the association chooses to pursue certain alternative supervision models for care provided in EDs in remote rural areas that cannot meet such a requirement due to workforce limitations, ensuring that exceptions only apply where needed. These exceptions shall preserve 24/7 physician supervision of the ED and provide for the availability of a physician to provide on-site care.
Corporate Practice of Medicine
Our AMA vigorously opposes any effort to pass legislation or regulation that removes or weakens state laws prohibiting the corporate practice of medicine
Our AMA opposes the corporate practice of medicine and supports the restriction of ownership and operational authority of physician medical practices to physicians or physician-owned groups.
Provider Credentialing
RESOLVED, that our American Medical Association urge the US Department of Labor to establish uniform provider credentialing standards for Third Party Administrator’s (TPA’s) serving ERISA Plans to include the following:
- that when a credentialing application is submitted, the insurance carrier must respond in writing within five business days whether the application is complete and acceptable, and
- if incomplete the carrier must send notice to the provider indicating what additional information is needed for completion of the process, and
- acknowledge the completion of a successfully completed application within ten business
Augmented Intelligence (AI) in Health Care
Sections of this lengthy AMA action address:
- National governance policies
- Transparency and disclosure of use of AI
- Physician liability associated with use of AI
- Data privacy
- Cybersecurity
- Mitigation of misinformation
- Payor use of AI in decision making
Combatting the illicit fentanyl crisis
RESOLVED, that our American Medical Association advocate for public education and awareness about the rapidly evolving US illicit drug crisis due to dangers of fentanyl and carfentanil-laced products; and be it further
RESOLVED, that our AMA advocate that federal, state and local government officials and agencies implement measures to curb and/or stop the manufacturing, importation, and distribution of illicit drugs and related chemical compounds; and be it further
RESOLVED, that our AMA support federal legislation that would help Customs and Border Protection (CBP) stop the flow of illicit goods, including fentanyl and counterfeit medications.
Improving rural obstetrical care
RESOLVED, that our American Medical Association strongly supports federal legislation that provides funding for the creation and implementation of a national obstetric emergency training program for rural health care facilities with and without a dedicated labor and delivery unit; and be it further
RESOLVED, that our AMA supports the expansion and implementation of innovative obstetric telementoring/teleconsultation models to address perinatal health disparities and improve access to evidence-informed perinatal care in rural communities; and be it further
RESOLVED, that our AMA encourages academic medical centers and health systems to actively participate in obstetric telementoring/teleconsultation models to support rural physicians and advanced practice providers and improve perinatal health outcomes in rural communities.
ED boarding
RESOLVED, that our American Medical Association immediately collaborate with stakeholders such as hospitals, insurance companies, CMS, and joint commission to resolve this issue; and be it further
RESOLVED, that our AMA advocate strongly for appropriate staffing ratios and appropriate care for patients and the emergency room and those admitted but still physically located in the emergency room to decrease patient harm and physician and nurse burnout.
Outcomes measures
RESOLVED, that our American Medical Association will make public statements calling for a removal of any/all unproven outcomes measures and associated mandates placed on physicians, practices, licensed clinics, nursing homes, hospitals and other places of healthcare; and be it further
RESOLVED, that our AMA will seek legislation or regulation removing any/all unproven outcomes measures and associated mandates placed on physicians, practices, licensed clinics, nursing homes, hospitals and other places of healthcare.
Collective negotiation with hospitals and health systems
RESOLVED, that our American Medical Association develop and distribute comprehensive materials to enable medical staffs to become effective agents for collective negotiation with hospitals and health systems; and be it further
RESOLVED, that our AMA allocate appropriate resources and support to assist medical staffs in understanding their rights, the negotiation process, and strategies for successful collective action; and be it further
RESOLVED, that our AMA advocate for policies at the state and federal levels that support the rights of medical staffs to engage in collective negotiation with hospital systems.
Gender-affirming care
That our AMA unambiguously supports access to and insurance coverage of medically necessary gender-affirming care but does not identify a preferred model of care for determining medical necessity.
Our AMA supports public and private health insurance coverage for evidence-based treatment of gender-affirming care gender dysphoria as recommended by the patient’s physician.
Facility fee transparency
RESOLVED, that our American Medical Association advocate for legislation or regulation that mandates the proactive transparency of the added costs to the consumer for health care services rendered at hospital outpatient department designated clinics; and be it further
RESOLVED, that our AMA advocate the additional costs of facility fees over professional services be stated upon scheduling of such services, noting the two are separate and additive charges, as well as prominently displayed at the point of service.
Biosimilars
That our American Medical Association (AMA) support the development and implementation of strategies to incentivize the use of lower cost biosimilars when safe, fiscally prudent for the patient, clinically appropriate, and agreed upon as the best course of treatment by the patient and physician.
Payment for pre-authorized procedures
RESOLVED, that our American Medical Association support the position that the practice of retrospective denial of payment for care which has been pre-certified by an insurer should be banned, except when false or fraudulent information has knowingly been given to the insurer by the physician, hospital or ancillary service provider to obtain pre-certification; and be it further
RESOLVED, that our AMA continue to advocate for legislation, regulation, or other appropriate means to ensure that all health plans including those regulated by ERISA, pay for services that are pre-authorized, or pre-certified by such health plan, including services that are deemed pre-authorized or pre-certified because the physician participates in a “Gold Card” program operated by that health plan.
Cannabis therapeutic claims
That our AMA:
- a) Oppose cannabis and cannabis-based product advertising that includes claims or statements that are not supported by scientific evidence.
- b) Will continue to monitor regulatory approaches to cannabis marketing.
Heat alert and response plans
RESOLVED, that our American Medical Association supports federal, state, and local efforts to use the most updated and evidence-based heat index formulas and other relevant factors to accurately estimate heat-related morbidity and mortality, proactively issue heat alerts, and improve implementation of response plans.
Radiation exposure – healthcare workers
RESOLVED, that our American Medical Association encourage public and private healthcare institutions to ensure more comprehensive coverage of different body types by providing PPE that more completely protects employees of all genders and pregnancy statuses, such as lead and lead-free aprons with capped sleeves, axillary supplements, and maternity aprons.
The AMA House of Delegates will next convene over the dates of June 6-11, 2025 in Chicago.
The AMA’s National Advocacy Conference is scheduled for February 10-12, 2025. You are encouraged to join members of the NC Medical Society in going to Capitol Hill to help advance our health policy priorities. Registration is open.