The ACR and its delegation to the American Medical Association (AMA) House of Delegates (HOD) capped a busy and highly successful interim HOD meeting Nov. 8–12 in Orlando. Hundreds of delegates from medical specialty societies and state medical associations gather at two AMA HOD meetings each year—in June and November—to set the policy and direction for the nation’s largest and most powerful physician organization. The November interim meeting is the smaller of the two and usually includes fewer resolutions.
The ACR’s resolution at this meeting—Medicare payment parity for telemedicine—was supported by several delegations and the Specialty and Service Society (SSS) of the AMA, and it was recommended for reaffirmation. The ACR delegation also worked to shape policy discussions in a number of other areas affecting members. Topics addressed included updates to Medicare Physician Fee Schedule payments, budget cuts and budget neutrality issues, approaches to sustaining community practices, artificial intelligence in healthcare, prior authorization and many more.
ACR members are encouraged to suggest topics of focus for future ACR resolutions by writing to [email protected]. Many ACR-developed policies and directives have been previously passed by the AMA, addressing issues including copay accumulator policy, third-party pharmacy benefit administrators, stakeholder engagement with Medicare Administrative Contractors, payer financial incentives to switch treatments, selective application of prior authorization, step therapy in Medicare Advantage, biosimilar interchangeability pathways, ensuring an effective H-1B visa program to enhance the rheumatology workforce, drug pricing, drug cost attribution in quality payment programs, pharmacy benefit manager (PBM) reform, opposing the previous Medicare Part B drug payment demonstration and more.
Medicare Payment Parity for Telemedicine
Resolution 227, which addressed Medicare payment parity for telemedicine, was developed by the ACR. Due to the AMA having existing policy that supports the expansion of telemedicine in Medicare, as well as having standing policy that prohibits the AMA from advocating for the valuation of CPT codes, the resolution was recommended for reaffirmation.
The ACR will continue its initiative to develop policy based on the priorities of rheumatologists and coalesce around the support of other concerned stakeholder specialty societies. This advocacy and coalition-building is made possible because ACR members join and maintain memberships in the AMA, allowing the delegation representation at the meeting. Join now to not only access benefits for yourself, but also to support this work to elevate rheumatology issues at the national level.
Therapy Cap Exception Process
The HOD passed Resolution 812, authored by the Michigan Delegation and cosponsored by the ACR, to require all health plans with therapy caps or thresholds to include an exception process that, at a minimum, follows the Medicare standard for therapy cap exceptions.
