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Health care reform, MOC among issues discussed at AMA meeting :

December 20, 2016

The American Medical Association (AMA) House of Delegates 2016 interim meeting began two days after the 2016 election results were announced, and the main topic of discussion was the future of the Affordable Care Act and how the AMA should proceed in working with the new president and Congress.

Based on testimony and debate, the AMA Statement on the Future of Health Care Reform was released (see below).

There also was much concern about possible changes in immigration policies and their effect on immigrant children and families residing in the U.S., including those involved in health care. A resolution titled “Support for DACA-Eligible Healthcare Professionals” was adopted. It directs the AMA to issue a statement in support of current U.S. health professionals, including those currently training as medical students or residents and fellows, who are Deferred Action for Childhood Arrivals recipients.

Following is a summary of other pediatric-related topics discussed at the meeting.

Disparities in education

Based on the expert testimony of then-AAP President Benard P. Dreyer, M.D., FAAP, a resolution titled "Disparities in Public Education as a Crisis in Public Health and Civil Rights" was amended by addition to acknowledge the role of early childhood brain development in persistent educational and health disparities. The addition also called for strengthening and expanding programs that support optimal early childhood brain development and school readiness.

Lead exposure in children

The AMA is proposing the establishment of national goals to ensure that no child has a blood lead level of >5 micrograms/deciliter (μg/dL) by 2021 and that by 2030, no child has a blood lead level of >1  μg/dL.

Strategies include identifying and remediating current and potential new sources of lead exposure in soil, dust, air, water and consumer products; continued targeted lead screening of children; and eliminating new sources of lead into the environment.

Reducing firearm injuries

The AMA endorsed and will lobby for adoption of the publication Firearm-Related Injury and Death in the United States: A Call to Action From 8 Health Professional Organizations and the American Bar Association. The Academy is among the societies that took part in authoring the recommendations, which target reducing the health and public health consequences of firearms.

Teen Health Week

The AMA will promote Teen Health Week 2017, Jan. 9-13, and encourages state medical associations and specialty medical associations across the nation to do the same. The goal is for Teen Health Week to become an annual event.

Maintenance of Certification

As has been the case at past meetings, the House of Delegates introduced additional resolutions related to Maintenance of Certification (MOC). The AMA accepted the resolutions and modified extensive policy that MOC should not be mandated for licensure, credentialing, re-credentialing, privileging, reimbursement, network participation, employment or insurance panel participation.

Issues affecting trainees

There was a strong focus on ensuring confidential mental health services to medical students and residents.

The Academy rose in strong support of student and resident programs providing protected time and locations for breastfeeding trainees.

Residents in training routinely prescribe controlled substances for their patients, including opioid pain medications. However, most state laws do not explicitly grant them access to their Prescription Drug Monitoring Programs (PDMP). A resolution was passed supporting regulatory action that would authorize all prescribers of controlled substances, including residents, to have access to their state PDMP.

AAP delegation

The 2016 AAP delegation to the AMA House of Delegates included Charles J. Barone II, M.D., FAAP (chair); Errol R. Alden, M.D., FAAP; Carol D. Berkowitz, M.D., FAAP; Melissa J. Garretson, M.D., FAAP; Samantha Rosman, M.D., FAAP; Toluwalase Ajayi, M.D.; and David T. Tayloe Jr., M.D. FAAP.

Alternate delegates included AAP Immediate Past President Benard P. Dreyer, M.D., FAAP; AAP CEO/Executive Vice President Karen Remley, M.D., M.B.A., M.P.H., FAAP; and AAP Senior Vice President, Global Child Health, Research and Policy Jonathan D. Klein, M.D., M.P.H., FAAP.

The following AAP Fellows also serve in leadership positions within the AMA:

Board of Trustees: Susan R. Bailey, M.D., FAAP (speaker of the House of Delegates); Council on Medical Service: Lynda M. Young, M.D., FAAP (member); Council on Medical Education: Dr. Berkowitz (member); Council on Legislation: Dr. Tayloe (member); Council on Long Range Planning and Development: Matthew E. Lecuyer, M.D. (Resident and Fellow Section member); Council on Ethical and Judicial Affairs: Kathryn L. Moseley, M.D., M.P.H., FAAP (member); Council on Science and Public Health: Kira Geraci-Ciardullo, M.D., M.P.H., FAAP (member); Young Physicians Section: Dr. Ajayi (member) and Henry Lin, M.D., FAAP (chair); AAP Resident and Fellow Section Delegates: Erin Schwab, M.D., and Megan Yanik, M.D.; AAP members of the Resident and Fellow Section Assembly: Rachel Holcomb, M.D., and Bihn Vu, M.D.; AAP Medical Student Section Delegate: Zarah Iqbal.

AMA Statement on the Future of Health Care Reform

“The AMA House of Delegates, reflecting more than 170 state and specialty medical societies from across the country, today reaffirmed its commitment to health care reform that improves access to care for all patients.

“Using a comprehensive policy framework that has been refined over the past two decades, the AMA will actively engage the incoming Trump Administration and Congress in discussions on the future direction of health care. The AMA remains committed to improving health insurance coverage so that patients receive timely, high quality care, preventive services, medications and other necessary treatments.

“A core principle is that any new reform proposal should not cause individuals currently covered to become uninsured. We will also advance recommendations to support the delivery of high quality patient care. Policymakers have a notable opportunity to also reduce excessive regulatory burdens that diminish physicians’ time devoted to patient care and increase costs.”

“Health care reform is a journey involving many complex issues and challenges, and the AMA is committed to working with federal and state policymakers to advance reforms to improve the health of the nation.”

Dr. Barone is chair of the AAP delegation to the AMA House of Delegates.

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