AMA House of Delegates: This Timeline Grows Short

AMA House of Delegates: This Timeline Grows Short

Edward P. Balaban, FACP, DO, FASCO

Nov 19, 2018

ASCO’s delegation to the AMA House of Delegates gathered at the Gaylord National Harbor Resort in Maryland (the Washington, DC, metro area) last weekend. We—Drs. Tom Marsland, Ray Page, Steve Lee, Kristina Novick, Erin Straub, and I—presented concerns focused on the Competitive Acquisition Program (CAP), among a variety of other issues.

In regards to CAP we proposed an ASCO resolution that the AMA advocate for this program to be voluntary and have some form of flexibility, as well as remuneration for drug handling, complex care coordination, include vendor competition, and ultimately should not interfere or delay patient care. There was a last-minute language change added by our colleagues from the American College of Rheumatology that strengthened the overall proposal. This was accepted and adopted.

Another proposal centering on opposition to Medicare’s proposal to categorize Medicare Part B drugs into Part D drugs was also adopted. We were also able to further receive AMA’s continued and concentrated advocacy on rejecting CMS plans to incorporate step therapy with Medicare Advantage plans that is now scheduled to go into effect on January 1.

We either cosponsored or vigorously supported a number of other proposals. For instance, there were two proposals focused on the funding of breast cancer imaging in the setting of “dense breast” findings as well as the inclusive funding of breast surgery to include any surgical reconstructive therapy considered post treatment. We backed a late resolution highlighting that some patients require higher doses of opioid medications for pain control than recognized by the CDC Guideline for Prescribing Opioids for Chronic Pain. In summary, this resolution stressed that the CDC guidelines should not be used as an all-encompassing blanket statement (by all agencies involved in drug prescribing) that would limit appropriate opioid accessibility. The CDC guidelines should only be interpreted as “guidance” and not misapplied to ultimately limit patient access to these drugs and potentially provoke physician professional discipline. The Pain and Palliative Medicine Section Council, of which ASCO has been a longtime participant, proposed this resolution. In addition, there were a number of Board reports and other resolutions that the delegation would testify in “support of” or “opposition to” in line with ASCO policy.

I become more and more impressed that the timeline linked to our chief concerns as the practice of medical oncology (and the medical community in general) evolves becomes increasingly short. We meet every 6 months and every interval brings a fresh and frequently a variety of urgent issues. To be successful, then, a very close and at times rather nimble connection with ASCO as well as with our colleagues at the AMA is an absolute necessity. As I have stated several times in this blog, the physician delegation relies heavily on our wonderful ASCO staff. We may at times not all agree, but ultimately the delegation chemistry will get us to the right and best solution. I have little doubt that everyone feels this shortened timeline. We have already formulated ideas for the next meeting and look forward to input for comments/concerns from ASCO members and committees. This timeline will be brief so stay connected, involved, and share thoughts.


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