AMA House of Delegates: Nothing Is Done Without Your Help

AMA House of Delegates: Nothing Is Done Without Your Help

Edward P. Balaban, FACP, DO, FASCO

Dec 03, 2019

ASCO’s delegation to the American Medical Association (AMA)—Drs. Tom Marsland, Ray Page, Erin Schwab, Kristina Novick, Steve Lee, and yours truly—just returned from the interim meeting of the AMA House of Delegates (HOD). The delegation once again experienced a very successful gathering.

ASCO-led resolutions that were adopted included the promotion of patient protections from “step therapy” beyond Medicare Advantage. Specifically, this resolution called on the placement of appropriate patient safeguards as well as the ability of implementing physician-directed patient safeguards with any form of “step therapy.”

We also shared concerns around a Centers for Medicare and Medicaid Services (CMS) call for “immediate” availability of medical test results. The discussion revolved around the likelihood of patient confusion and anxiety as results are potentially viewed prior to physician review. We emphasized the currently flawed vendor-controlled electronic health record technology that limits physician discretion for patient information review and release. The result of our concerns will lead to the AMA working with CMS and appropriate offices to develop safety guardrails on the dissemination of health-related information as well as working with vendors to “implement mechanisms that provide physicians the discretion to publish medical test results to a patient portal while ensuring patient access to such information in a reasonable timeframe.”

We also pursued support for pharmacy benefit managers (PBMs) and health plans to adopt formularies using a transparent value-based decision-making framework with clinician oversight pertaining to specialty drug determination. Existing AMA policy originally reaffirmed this resolution. The delegation extracted this for discussion, emphasizing the need for value-based formularies and particularly the need for physician oversight. After much debate, the HOD referred the resolution for study. I suspect we will hear more within the next year.

In addition to ASCO-led efforts, we also cosponsored a resolution with colleagues from the American College of Rheumatology supporting the need for “PBMs and state regulatory bodies to make rebate and discount reports and disclosures available to the public.” This was also adopted.

Finally, the cancer caucus, conducted and led by ASCO, grows in number and influence.

The AMA House of Delegates meets twice a year. The preparation for these meetings is quite extensive and involves a number of dedicated ASCO staff. None of this would be possible without their help.

These meetings have been and will continue to play an important role in messaging the needs of oncology to the medical community. The AMA-HOD has been and will continue to be a powerful effective venue to act on these needs. We invite all ASCO members and committees to share their thoughts and concerns concerning issues affecting the practice of oncology with this delegation. We would also encourage ASCO members to consider membership in the AMA to help grow the size of this delegation. We have been able to foster a significant relationship within the AMA. However, the delegation and its staff rely solely on the needs of ASCO membership and policy. Nothing is done without your help and input.


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