The AMA House of Delegates (AMA-HOD) recently convened in Chicago. ASCO’s delegation to the AMA-HOD had a very successful meeting. The delegation includes Drs. Tom Marsland, Kristina Novick, Steve Lee, Ray Page, Erin Schwab, and me, as well as a very active and much appreciated ASCO staff. A number of issues/resolutions were either primarily sponsored by ASCO or cosponsored with other societies. Topics presented and adopted included:
- The recognition that any alcohol ingestion is a causation risk factor for certain neoplasms
- A need to relook at continued AMA support of the National Guidelines Clearinghouse
- The clarification that specialty-specific guidelines, such as those authored by ASCO for management of cancer-related chronic pain and end-of-life and palliative care, are more appropriate for the oncology setting than the CDC’s Guideline for Prescribing Opioids for Chronic Pain. In addition we applauded the AMA’s ongoing support of appropriate exemptions from opioid prescribing limits.
Other (co-sponsored) topics included the Selective Application of Prior Authorization (this was reaffirmed into prior AMA policy) and continued work with Congress regarding patient safeguards in utilization management. This included opposition to step therapy in cancer treatment as CMS rules for Medicare Advantage Plans evolve (this resolution was adopted).
A very important issue led by ASCO addressed an AMA-authored Board of Trustees report addressing “Handling of De-identified Patient Information.” The draft report suggested re-examination—and possibly new limitations—on the use of de-identified aggregated patient data. Such a consideration could threaten the viability of clinical data registries operated by many professional medical societies, including ASCO, for purposes of quality improvement and evolving rapid-learning health system initiatives. We were able (along with several other societies) to have this report withdrawn and referred back for additional consideration by the AMA Board of Trustees. ASCO has requested that further analysis of this important issue be done in conjunction with relevant societies. Communication by ASCO with the AMA has already begun.
The ASCO-led cancer caucus has grown in size and influence. The caucus was requested to support a resolution addressing a recent Nuclear Regulatory Commission-proposed rule that would reduce training requirements for those who handle radiopharmaceuticals. This important resolve came from the Resident Fellow Section at the AMA-HOD. The resolution was adopted.
A wide range of other supported subjects included pharmacy benefit manager (PBM) transparency issues, rural health disparities, and vaping nicotine concerns.
This blog is meant to be brief; however, our activities and overall impact at the AMA-HOD has grown. As ASCO’s Dr. Barbara McAneny brought her year-long AMA presidency to a close, her comment that there is so much more to do cannot be overstated.