The AMA's House of Delegates is the policy-making body at the center of American medicine, bringing together an inclusive group of physicians, medical students and residents representing every state and medical field. Delegates work in a democratic process to create a national physician consensus on emerging issues in public health, science, ethics, business and government to continually provide safer, higher quality and more efficient care for patients and communities.
The policies adopted by the House of Delegates today include:
Taking Bold Steps to Prevent Physician Identity Theft
Across the country, hundreds of physicians and other health professionals in at least 18 states have been the targets of tax fraud involving identity theft and the filing of fraudulent federal income tax returns. These malicious acts of fraud have resulted in a significant loss of time and effort by physicians who have had to submit paper returns and additional information as proof of their identity. It has also resulted in a significant loss of revenue to the federal government for fraudulent rebate checks. Today, the AMA adopted new policy to request that the Internal Revenue Service (IRS) and the Centers for Medicare and Medicaid Services (CMS) adopt regulations to prohibit the use of social security numbers by insurers, health care vendors and other government agencies.
"Identity theft is one of the fastest growing crimes nationwide and the AMA is committed to taking bold steps to ensure physicians are protected," said incoming AMA Board Chair Barbara McAneny, M.D. "We believe the IRS should adopt policies that would assure greater security protection for electronically filed federal income tax returns including the use of universal PINS, or personal identification numbers that would help curb the incidence of identity theft and the filing of fraudulent federal income tax returns."
Banning Smoking While Driving in Vehicles Where Minors Are Present
Studies suggest that children are more vulnerable than adults to second-hand smoke and that second-hand smoke can increase likelihood of ear disease, lower respiratory infections and asthma. The AMA is dedicated to reducing exposure to second-hand tobacco smoke for both children and adults and voted today to add to its policies on the topic, strengthening its support of tobacco-free and smoke-free environments. The new policy supports legislation that prohibits smoking while operating or riding in a vehicle with children - similar to policies in effect in Arkansas, California, Louisiana, Maine, Oregon, Utah and Puerto Rico.
"The dangers of second-hand smoke are marked and proven, and no one is more at risk than our youth," said William Kobler, MD, member of the Board of Trustees. "It is important that we do all that we can to reduce exposure to second-hand smoke by supporting smoke-free environments, including vehicles."
The AMA already has policy recognizing the dangers of second-hand smoke and supporting the prohibition of smoking in multi-unit housing and making public spaces and workplaces smoke-free.
AMA Continues to Seek Solutions to address CMS "Observation Status" Rules
With a keen focus on patient awareness, safety and costs of care, the AMA today adopted new policy that reinforces physician concerns about the Centers for Medicare & Medicaid Services (CMS) hospital observation rules. Hospital patient observation status is typically used by Medicare to minimize costs, but patients in observation status frequently require the same hospital services as those who are admitted as inpatient. In fact, in 2012 Medicare patients reportedly had 1.5 million observation stays, more than 92 percent of which spanned a night or more in the hospital. Lengthy observation stays can financially overwhelm patients who are unaware of their status. Additionally, patients categorized as observation status may receive limited or no discharge planning, which presents serious patient safety issues. Today's policy encourages CMS to educate the public and develop new tools for physicians and patients that outline the impact of the "two midnight" policy.
"We have an obligation to ensure patients are receiving the right care, at the right time, in the right setting and at the right cost," said AMA Board Member Albert Osbahr, M.D. "This new AMA policy seeks to ensure CMS develops payment solutions that address the inappropriate use of hospital observation status in order to curb unnecessary costs and better serve patients."
Expanding Maternity Care Coverage for Young Women Under the Affordable Care Act
The Affordable Care Act (ACA) allows young adults to stay on their parents' health insurance policy until age 26. This extension can increase the chance that female dependents could become pregnant while covered under their parents' plan. In fact, in 2013, the average age for woman to have her first child was 25.7 and the average cost of care for a vaginal delivery was more than $32,000. In an effort to ensure there is no gap in coverage for young, pregnant mothers and their newborns, and to ensure female dependents receive comprehensive and complete maternity care, the AMA today adopted new policy. The policy advocates for large group health plans to expand coverage of maternity care to dependent women under age 26 who are covered under their parent's health plans. The policy also seeks 60 days of newborn coverage for all infants who are born to dependent women under age 26.
"Dependent coverage without maternity care benefits is incomplete and could impose substantial costs on young mothers and their parents," said AMA Board Member Albert Osbahr, M.D. "This policy is consistent with existing AMA policy, which encourages comprehensive maternity coverage for all women, and health insurance coverage for the care of newborns from the moment of birth."
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