At the upcoming American Medical Association (AMA) House of Delegates (HOD) Annual Meeting June 9–14 in Chicago, the ACR will co-lead with the American Society of Clinical Oncology a resolution on in-office dispensing of specialty drugs. Additionally, the ACR authored and will lead 10 other specialty societies to advance a resolution on the proposed NIH Public Access Plan and its potential adverse consequences for equitable access to quality clinical research.
Close to 500 resolutions and reports have been filed for consideration at the AMA’s June HOD meeting, at which delegates from medical specialty societies and state medical associations will set policy and direction for the nation’s largest physician organization. Topics slated to be addressed include: updates to Medicare Physician Fee Schedule payments, budget cuts and budget neutrality issues, approaches to sustaining community practices, biosimilars policies, artificial intelligence in healthcare, prior authorization and many more issues that impact rheumatology and rheumatology practices.
In-Office Specialty Drug Dispensing
The ACR will lead two resolutions at this meeting. First, the ACR has joined with the American Society of Clinical Oncology to advance resolution 246, which would provide protections for practices related to office-based dispensing of specialty drugs.
This resolution would have the AMA request that the Centers for Medicare & Medicaid Services (CMS) rescind its recent determination that delivery of medicine to a patient using the U.S. Postal Service, a commercial package service or a trusted surrogate violates the in-office exception of the physician self-referral law, commonly referred to as the Stark Law. Additionally, if the CMS were to not change its position on disallowing the delivery of medicine to a patient using the U.S. Postal Service or a commercial package service, the resolution would have the AMA call for legislation to clarify that a surrogate may deliver medicine dispensed at a physician-owned pharmacy without being in violation of the Stark Law.
The Stark Law prohibits physicians from making referrals to entities in which they have a financial relationship, unless an exception applies (common exceptions include in-office ancillary services, so that physicians can furnish designated health services to their practice’s patients). In-office dispensing of medication has been associated with improved patient access and adherence. Although the provisions of this resolution will not prevent insurers, PBMs and others from requiring selected delivery mechanisms (such as white bagging, brown bagging, etc.) to drive down costs by restricting patient choice, clarifying this exception to the Stark Law would ensure physician practices that utilize an in-office pharmacy would be able to choose the best delivery method for their individual patients.
