December-January 2017

Highlights from AMA’s interim meeting

The American Medical Association (AMA) held its interim meeting for 2016 in Orlando in November.

Georgia AMA Delegation Chair William Clark III, M.D., reports that Georgia’s delegation introduced a number of key resolutions, including…

Resolution 220, which called for AMA to develop model state legislation to address distracted drivers. HOD Action: Adopted.

Resolution 221, which called for AMA to advocate for physicians to be able to recover EMR fees. HOD Action: Reaffirmed existing policy (D478-972).

Resolution 817, which called for AMA to address brand and generic drug costs. HOD Action: Reaffirmed existing policy (H-110.988).

Resolution 818, which called for AMA to take steps to improve communications among health care clinicians. HOD Action: The HOD passed Resolution 818 with amendments that calls for AMA to “1) support making hospital discharge instructions available to patients in both printed and electronic form, and specifically via online portals accessible to patients and their designated caregivers and 2) develop model guidelines for physicians to improve communications to other physicians, hospital staff, and patients, and promote these guidelines to payers, hospitals and patients and 3) Adopt Council on Medical Service Report 7, which recommends that our AMA reaffirm Policies D-478.995, H-160.942 and D-160.945.”

Resolution 819, which called for AMA to address nonpayment for unspecified codes by third party payers. HOD Action: Reaffirmed existing policy.

D-100.983, which called for AMA to address prescription drug importation and patient safety by “1) supporting the legalized importation of prescription drug products by wholesalers and pharmacies only if: a) all drug products are Food and Drug Administration (FDA)-approved and meet all other FDA regulatory requirements pursuant to U.S. laws and regulations and b) the drug distribution chain is ‘closed,’ and all drug products are subject to reliable, ‘electronic’ track and trace technology and c) the Congress grants necessary additional authority and resources to the FDA to ensure the authenticity and integrity of prescription drugs that are imported and 2) oppose personal importation of prescription drugs via the Internet until patient safety can be assured and 3) review the recommendations of the forthcoming report of the Department of Health and Human Services (HHS) Task Force on Drug Importation and, as appropriate, revise its position on whether or how patient safety can be assured under legalized drug importation and 4) educate its members regarding the risks and benefits associated with drug importation and reimportation efforts.” HOD Action: Reaffirmed existing policy (BOT Rep. 3, I-04; Reaffirmation A-09).

H-120.934, which called for AMA to “support regulatory changes to improve access to 1) the compounding and repackaging of manufactured FDA-approved drugs and substances usually prepared in the office-based setting and 2) purchasing from compounding pharmacies of FDA-approved drugs, repackaged or compounded for the purpose of in-office use.” HOD Action: Reaffirmed existing policy (Res. 207, A-15 Reaffirmed: CMS Rep. 04, A-16 Reaffirmed: Res. 204, A-16).

H-120.945, which called for AMA to “1) recognize that traditional compounding pharmacies must be subject to state board of pharmacy oversight and comply with current U.S. Pharmacopeia and National Formulary (USP-NF) compounding monographs, when available, and recommends that they be required to conform with USP-NF General Chapters on pharmaceutical compounding to ensure the uniformity, quality, and safety of compounded medications and 2) encourages all state boards of pharmacy to reference sterile compounding quality standards, including but not limited to those contained in U.S. Pharmacopeia Chapter 797, as the standard for sterile compounding in their state, and to satisfy other relevant standards that have been promulgated by the state in its laws and regulations governing pharmacy practice and 3) supports the view that facilities (other than pharmacies within a health system that serve only other entities within that health system) that compound sterile drug products without receiving a prescription order prior to beginning compounding and introduce such compounded drugs into interstate commerce be recognized as compounding manufacturers subject to FDA oversight and regulation and 4) supports the view that allowances must be made for the conduct of compounding practices that can realistically supply compounded products to meet anticipated clinical needs, including urgent and emergency care scenarios, in a safe manner and 5) in the absence of new federal legislation affecting the oversight of compounding pharmacies, continues to encourage state boards of pharmacy and the National Association of Boards of Pharmacy to work with the FDA to identify and take appropriate enforcement action against entities that are illegally manufacturing medications under the guise of pharmacy compounding. HOD Action: (BOT action in response to referred for decision Res. 521, A-06; Revised: CSAPH Rep. 9, A-13).

D-120.949, which called for AMA to “1) monitor ongoing federal and state evaluations and investigations of the practices of compounding pharmacies and 2) encourage the development of regulations that ensure safe compounding practices that meet patient and physician needs and 3) report back on efforts to establish the necessary and appropriate regulatory oversight of compounding pharmacy practices. HOD Action: Reaffirmed existing policy (Sub. Res. 923, I-12; Reaffirmed: Res. 204, A-16).

H-110.987, which called for AMA to “1) encourage FTC actions to limit anti-competitive behavior by pharmaceutical companies attempting to reduce competition from generic manufacturers through manipulation of patent protections and abuse of regulatory exclusivity incentives and 2) encourage Congress, the FTC and HHS to monitor and evaluate the utilization and impact of controlled distribution channels for prescription pharmaceuticals on patient access and market competition and 3) monitor the impact of mergers and acquisitions in the pharmaceutical industry and 4) continue to monitor and support an appropriate balance between incentives based on appropriate safeguards for innovation on the one hand and efforts to reduce regulatory and statutory barriers to competition as part of the patent system and 5) encourage prescription drug price and cost transparency among pharmaceutical companies, pharmacy benefit managers and health insurance companies and 6) support legislation to require generic drug manufacturers to pay an additional rebate to state Medicaid programs if the price of a generic drug rises faster than inflation and 7) support legislation to shorten the exclusivity period for biologics and 8) convene a task force of appropriate AMA Councils, state medical societies, and national medical specialty societies to develop principles to guide advocacy and grassroots efforts aimed at addressing pharmaceutical costs and improving patient access and adherence to medically necessary prescription drug regimens and 9) generate an advocacy campaign to engage physicians and patients in local and national advocacy initiatives that bring attention to the rising price of prescription drugs and help to put forward solutions to make prescription drugs more affordable for all patients, and will report back to the HOD regarding the progress of the drug pricing advocacy campaign at the 2016 Interim Meeting.” HOD Action: Reaffirmed existing policy (CMS Rep. 2, I-15).

H-110.989, which called for AMA to “1) support the FTC in its efforts to stop ‘pay for delay’ arrangements by pharmaceutical companies and 2) federal legislation that makes tactics delaying conversion of medications to generic status, also known as ‘pay for delay,’ illegal in the U.S.” HOD Action: Reaffirmed existing policy (Res. 520, A-08 Appended: Res. 222, I-12; Reaffirmed: CMS 2, I-15).

H-155.962, which called for AMA to “oppose the use of price controls in any segment of the health care industry, and continues to promote market-based strategies to achieve access to and affordability of health care goods and services.” HOD Action: Reaffirmed existing policy (CMS Rep. 2, A-07; Reaffirmed in lieu of Res. 201, I-11; Reaffirmed: CMS Res. 2, I-15).

H-110.988, which called for AMA to “1) work collaboratively with relevant federal and state agencies, policymakers and key stakeholders (e.g., FDA, FTC, and the Generic Pharmaceutical Association) to identify and promote adoption of policies to address the already high and escalating costs of generic prescription drugs and 2) advocate with interested parties to support legislation to ensure fair and appropriate pricing of generic medications, and educate Congress about the adverse impact of generic prescription drug price increases on the health of our patients and 3) encourage the development of methods that increase choice and competition in the development and pricing of generic prescription drugs and 4) support measures that increase price transparency for generic prescription drugs.” HOD Action: Reaffirmed existing policy (Sub. Res. 106, A-15; Reaffirmed: CMS 2, I-15).

The headlines from the meeting included…

– “AMA Adopts Policy to Urge Further Research into Detection and Prevention of CTE”

– “AMA Strengthens Anti-Tobacco Policies to Further Protect Youth”

– “AMA Urges Legislation to Ban Dangerous Coal-Tar Sealcoats”

– “AMA Endorses Important Framework to Promote Firearm Safety”

– “AMA Adopts Principles to Promote Safe and Effective Mobile Health Applications”

– “AMA [releases] Statement on the Future of Health Care Reform”

– “AMA Adopts Ethical Guidance on Team-Based Health Care”

– “AMA Urges Expanded Infertility Benefits for Veterans”

– “AMA Supports Changing the Fundamentals of Drug Pricing”

– “AMA Adopts New Policies to Support Medical Student and Resident Physician Wellness and Mental Health”

– “AMA Adopts New Policies to Further Innovative Efforts to Create the Medical School of the Future, Improve Treatment of Chronic Diseases”

– “American Medical Association Adopts New Policies to Improve Health of Nation”

– “AMA Presents Distinguished Service Award to Forensic Pathologist Who Discovered CTE”

Dr. Clark also notes that AMA’s Southeastern Delegation endorsed two MAG members for national positions in the 2018 election cycle, including Patrice Harris, M.D., for AMA president-elect, and Sandra Fryhofer, M.D., for AMA’s Board of Trustees.

In addition to Dr. Clark, Georgia’s AMA delegation includes Vice Chair Sandra B. Reed, M.D., Michael E. Greene, M.D., Joy A. Maxey, M.D., and Thomas E. Price, M.D. Georgia’s alternate delegates include John S. Antalis, M.D., Jack M. Chapman Jr., M.D., John A. Goldman, M.D., Billie Luke Jackson, M.D., and Gary C. Richter, M.D.

Go to /affiliates/american-medical-association for additional details on Georgia’s AMA delegation.

MAG members can contact Dr. Clark at swclark3@bellsouth.net with questions related to the AMA meeting.

Contact MAG Executive Director Donald J. Palmisano Jr. at dpalmisano@mag.org to obtain an AMA HOD resolution or reference committee report.

Click for ‘Top stories from the 2016 AMA Interim Meeting’

Click for AMA House of Delegates web page