The House of Delegates (HOD) is the policy-making body of the American Medical Association (AMA), and twice a year, representatives of all seated specialties, service societies and state medical associations review hundreds of resolutions to determine which will become AMA policies. Once those policies and priorities are determined or updated, we benefit from the AMA having one of the strongest lobbies for organized medicine. It is important and impactful for our rheumatology delegation to have a voice in HOD deliberations on behalf of ACR/ARP members—and this is possible only when enough ACR members are also members of the AMA.
The ACR can represent rheumatology and bring members’ concerns and issues to the AMA only because ACR members join or renew memberships in the AMA. You can make a difference and help these efforts by renewing your AMA membership or joining the AMA, and encouraging fellows to join, so rheumatology can continue to have a strong voice in the AMA’s HOD. It is important that every ACR member join and continue to renew their membership in the AMA, because the AMA continuously assesses the number of ACR members who are also AMA members, to determine the number of seats in the HOD that will be allotted to rheumatology.
Moving Issues Forward
At the most recent HOD meeting, which took place last month in Chicago, June 8–12, the ACR’s delegation advanced two resolutions on behalf of ACR/ARP members, one concerning prior authorization and another concerning step therapy.
The ACR and our partner societies sought support for exclusions from prior authorization requirements that delay patient care and increase administrative burden on physicians. We also sought expansion of patient protections with regard to step therapy, arguing the CMS has not yet done enough to protect patient access to life-saving drugs. Current regulatory guidance and proposed rules allow Medicare Advantage plans to use step therapy for Part B drugs and leave many patients unprotected in 2019 due to timing.
With the support of our co-sponsors—the American Society of Clinical Oncology, American Association of Clinical Endocrinologists and American Academy of Ophthalmology, as well as other specialty societies that testified—the ACR was able to successfully persuade the AMA to add to its policy our detailed patient protections with regard to step therapy in Medicare Advantage plans. This resolution will also result in AMA advocacy, with the CMS implementing patient protections for 2019 and beyond, if the policy allowing Medicare Advantage plans to use step therapy protocols is not rescinded.
