America's physicians demand action on gun violence
The AMA is calling for meaningful action to address the public health crisis of firearms violence. Two more horrific episodes shook the country last weekend with mass shootings in El Paso, Texas, and Dayton, Ohio, that left 31 dead and more than 50 wounded.
"The devastating gun-violence tragedies in our nation this weekend are heartbreaking to physicians across America," AMA President Patrice A. Harris, MD, MA, said in a statement Sunday. "We see the victims in our emergency departments and deliver trauma care to the injured, provide psychiatric care to the survivors and console the families of the deceased. The frequency and scale of these mass shootings demands action."
Nearly 40,000 Americans are killed each year in acts of firearms violence and about 85,000 more are injured, according to the Centers for Disease Control and Prevention. The AMA has been a long-time advocate for violence prevention and, after the 2016 Pulse nightclub shooting in Orlando, Florida, the Association adopted policy declaring that firearms violence is a public health crisis.
Read more on the AMA website and in the Annals of Internal Medicine, where the AMA joined a call to action with 6 of the nation's largest physician professional societies and the American Public Health Association, "Firearm-Related Injury and Death in the United States: A Call to Action from the Nation's Leading Physician and Public Health Professional Organizations."
Surprise billing: 4 points to raise with your members of Congress during recess
Congress is out of session for all of August, but there are opportunities for physicians to engage senators and representatives as they hold town halls and do other work back in their home districts. American physicians should know about the consequential legislation that has advanced on surprise medical bills and keep four key points in mind when raising the issue with their elected representatives in Congress during the August recess.
Physicians and others agree on this central tenet: Patients should be held harmless and not subject to bills higher than they would expect to pay had an in-network physician been available and there should be a fair system to resolve payment disputes between insurers and physicians.
Read more, including other key points to make with your congressional representatives, and access an action kit.
FDA unveils new drug importation plan
On July 31, the Trump administration announced new steps towards allowing the importation of certain drug products into the United States from foreign countries. An attempt to help ease pricing pressures on American patients, the Safe Importation Action Plan (PDF) would allow two potential pathways for importation—one authorizing demonstration projects to allow importation from Canada by states, wholesalers or pharmacies and one allowing importation by manufacturers that sell any drug in foreign countries, so long as the drug is the same as the U.S.-approved version. The administration plans to release a Notice of Proposed Rulemaking, as well as draft guidance to begin implementation of the new plan in the coming months.
The AMA has supported safe importation of drugs from other countries in certain circumstances to help source drugs that routinely have much lower prices in other countries. The administration's plan has been met with some skepticism, such as concerns in Canada about the potential impact on its drug supply and the exacerbation of drug shortages. Other concerns have been raised about the second pathway, with some saying it will allow drug manufacturers to avoid the current rebate system and work around current pharmacy benefit manager contacts without assurance of meaningful impact on drug list prices for American patients. The AMA is monitoring the development of this pathway and continues to work closely with the administration and Congress to find a path forward towards lower drug prices and out-of-pocket costs for patients.
CMS to score tobacco use measure as pay-for-reporting in the 2018 MSSP
As a result of concerns raised by the AMA and other organizations about substantive changes to the Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention measure (PREV-10/ACO-17) that is part of the 2018 Medicare Shared Savings Program (MSSP), the CMS has reclassified the measure as pay-for-reporting under the 2018 Shared Savings Program quality scoring methodology. The measure underwent substantive changes between 2017 and 2018 by eliminating the inclusion of non-tobacco users from the calculation of the performance score and as a result impacted scoring.
Additionally, the 2018 measure specification for the CMS Web Interface PREV-10 measure provided new guidance in a footnote that the timing of the tobacco cessation intervention had to occur during or after the most recent positive screen for tobacco use. Due to AMA advocacy, CMS has determined that the previously stated guidance is inconsistent with the intent of the CMS Web Interface version of this measure and substantive in nature.
For Merit-based Incentive Payment System (MIPS) alternative payment model (APM) participants subject to the APM scoring standard, the measure will be excluded from 2018 MIPS performance period score and will not contribute to their MIPS quality performance category score. Please note, this change only applies to the CMS Web Interface version of the measure and does not apply to any other collection type. Measure ACO-17 is also reported in MIPS as Measure 226. Therefore, the AMA will continue to advocate for the need for similar scoring accommodations for clinicians who reported the measure in 2018 MIPS through other collection types. The AMA does not believe CMS' policy of creating a benchmark based on the performance period sufficiently addresses the issue given the change was not clearly communicated at the start of the 2018 performance period.
For more information visit the Quality Payment Program resource library to view the 2018 CMS Web Interface measure specifications.
Physicians can contact the Quality Payment Program with any questions at [email protected] or 1-866-288-8292 (TTY: 1-877-715-6222).
