The ACR and its delegation to the American Medical Association (AMA) House of Delegates (HOD) capped a busy and highly successful annual HOD meeting June 7–12 in Chicago with the passage of a resolution supporting higher pediatric specialist compensation. The ACR’s resolution at this meeting—addressing Medicaid payment parity for pediatric specialists—was successfully passed, with some amendments, in the HOD and will be adopted by the AMA.
Gary Bryant, MD, chair of the ACR’s delegation, notes the dire and continuing workforce shortage in pediatric rheumatology, similar to the situation in some other specialties. “There are barely more than 300 pediatric rheumatologists nationwide to care for more than 300,000 children in the U.S. with rheumatic disease,” he says. “Medicaid is typically the lowest payer for physician services, so raising Medicaid payment to at least be on par with Medicare is an important step to incentivize career entry into pediatric specialty medicine.”
Hundreds of delegates from medical specialty societies and state medical associations gather at two AMA HOD meetings each year—in June and November—to set policy and direction for the nation’s largest and most powerful physician organization. A detailed rundown of the AMA’s policy development process can be found here.
The ACR delegation also worked to shape policy discussions in a number of other areas affecting members. Topics addressed at the HOD meeting included updates to Medicare Physician Fee Schedule payments, budget cuts and budget neutrality issues, approaches to sustaining community practices, biosimilar policies, artificial intelligence in healthcare, prior authorization and many more.
The new resolution adds to a long list of ACR-developed policies and directives passed by the AMA. Previous efforts have addressed copay accumulator policy, third-party pharmacy benefit administrators, stakeholder engagement with Medicare Administrative Contractors, payer financial incentives to switch treatments, selective application of prior authorization, step therapy in Medicare Advantage, biosimilar interchangeability pathways, ensuring an effective H-1B visa program to enhance the rheumatology workforce, drug pricing, drug cost attribution in quality payment programs, pharmacy benefit manager reform, opposing the previous Medicare Part B drug payment demonstration and more.
Pediatric Specialty Medicaid Reimbursement
Resolution 249, which addresses Medicaid reimbursement for pediatric specialists, was developed by the ACR in conjunction with five other specialty societies.
Joining the ACR’s resolution as cosponsors and calling for AMA involvement on this issue were the American Academy of Allergy, Asthma and Immunology; American Academy of Neurology; American Urological Association; Association for Clinical Oncology; and American Academy of Ophthalmology. Resolution 249 also gained support in many caucuses and section councils and support was expressed by the American Academy of Pediatrics, PacWest Healthcare and the AMA’s California Medical Association delegation, among others.
