The AMA is the largest group representing physicians in the U.S. and has tremendous advocacy resources to advance issues at both the federal and state levels. These issues include those important to rheumatology, such as reining in prior authorizations, reforming other payer and PBM practices, supporting workforce expansion and improving patient access to care in underserved areas.
Dr. Barré
“I have seen that the AMA is not a monolith; it is a parliamentary body that represents the views of its membership,” says Young Physician Section member Luke Barré, MD, MPH, RhMSUS. “Despite being a small specialty that frequently deals with rare diseases, our strong membership has made rheumatology an important voice at the AMA to raise issues that affect rheumatology as a specialty and our patients.”
The ACR estimates it needs over 1,300 ACR members who also belong to the AMA to keep rheumatology’s seats in the AMA House of Delegates, as well as to keep representation on the AMA Relative Update Committee (RUC) and the AMA CPT Advisory Committee.
The ACR’s current AMA delegation includes two delegates (Gary Bryant, MD, MACR, and Eileen Moynihan, MD), two alternate delegates (Cristina Arriens, MD, MSCS, and Colin Edgerton, MD), two Young Physician Section members (Dr. Barré and Christina Downey, MD), and one Resident/Fellow Section member (Rami Diab, MD). The delegates participate in two AMA HOD meetings per year (annual and interim) to discuss issues that are important to the rheumatology community and submit resolutions, explains Dr. Bryant. Resolutions that are accepted as AMA policy become part of the AMA’s official advocacy agenda, with varying levels of monetary support used to influence decisions in Congress, state legislatures and other key groups.
Dr. Bryant
The ACR delegation submitted multiple resolutions to the AMA HOD this year that were passed and became AMA policy, including two resolutions regarding PBM business practices. “The ACR’s ability to bring resolutions to the AMA HOD over the last several meetings strengthened AMA policy, enhanced advocacy around the ACR’s concerns with PBMs and had a significant impact on the recent decision by the FTC,” Dr. Bryant says. In a separate advocacy win for the ACR last month, the AMA HOD adopted the ACR’s resolution to address the lack of transparency around decisions made by Medicare Administrative Contractors.
Other rheumatology issues that the ACR has recently authored and led or co-sponsored actions on in the AMA House of Delegates include:
- Copay accumulator policies;
- Complex treatment administration and reimbursement;
- Payer financial incentives to patients for switching treatments;
- Mandatory payment models from CMMI;
- Home infusion issues;
- Biosimilar interchangeability;
- Drug pricing issues;
- Private payers and consultation codes;
- Prior authorization and Medicare Advantage; and
- Step therapy reform.
The ACR voice within the AMA is also enhanced through membership and participation in several caucuses within the AMA, including the Pain and Palliative Medicine Caucus, Mobility Caucus, Cancer Caucus (due to shared concerns regarding infused medications) and the Specialty and Service Society.
The Benefits of AMA Membership
In addition to securing the ACR’s advocacy voice within the AMA, being a member of AMA has a number of personal benefits, including access to research, education, practice insights, life insurance and other discounts. For those who serve as delegates, AMA membership can also provide a new way to support patient care, notes Dr. Barré.
Dr. Arriens
Dr. Arriens describes her experience as an ACR alternate delegate as eye-opening to see how the AMA serves as a megaphone to amplify advocacy support for issues important to rheumatology. “Issues that we have received help with from the AMA that have benefited me or my patients have included major changes to the ABIM MOC program, improvement of reimbursement for cognitive specialties like rheumatology, and improvement to access of biologic medications to my patients.” She has also seen the ACR bring forth issues that were not yet on other physicians’ radars, such as challenges with prior authorization and the current saline shortage. To this end, Dr. Arriens also stresses the important role all ACR members play in bringing issues to the ACR that are affecting their practices. “This communication is vital so that the ACR can advocate on their behalf, often through the AMA,” she notes.
Read more about the work of the ACR at the most recent AMA House of Delegates meeting in June.
Get the details on the FTC decision to investigate PBM business practices.
Carina Stanton is a freelance science journalist based in Denver.