AMA Advocacy issue briefs

Issue briefs summarize key health policy issues by providing concise and easily digestible content targeting both relevant stakeholders and those who may know little about the topic.

Important evidence-based information is communicated succinctly along with key advocacy messages and a summary of where the AMA stands. Accordingly, issue briefs are useful for education and advocacy purposes and are frequently employed in AMA advocacy efforts.

Through these issue briefs, the AMA helps physicians and policymakers build a better future for medicine by advocating to remove obstacles to patient care and confront current health crises.

1. Assuring access to Medicaid services (PDF)

   1. Federal Medicaid law’s equal access requirement and the CMS-issued final rule on state access monitoring review plans.

2. Medicaid managed care final rule (PDF)

   1. Major provisions, issues of importance to physicians and state implementation of the 2016 CMS-issued final rule on Medicaid managed care regulations.

3. Summary of research: Medicaid physician payment and access to care (PDF)

   1. Summary of conclusions drawn from existing research on Medicaid physician payment and access to care.

4. State advocacy roadmap: Medicaid access monitoring review plans (PDF)

   1. Provisions of federal Medicaid law’s equal access requirement where states should seek additional protections.

5. The evidence on Medicaid expansion (PDF)

   1. The importance of Medicaid expansion in increasing access to care, improving the lives of working Americans and benefiting the economy.

6. Opportunities in Medicaid: Improving cardiovascular health with self-measured blood pressure (PDF)

   1. Managing hypertension through expanded Medicaid coverage for self-measured blood pressure clinical services.

7. Integrated care for individuals dually eligible for Medicare & Medicaid (PDF)

   1. Issues to consider and AMA policy on integrated care models for individuals dually eligible for Medicare & Medicaid, who are more likely to experience inequities in social determinants of health.

8. Medicaid reform (PDF)

   1. Medicaid reform basics and where the AMA stands.

9. Payment variations across outpatient sites of service (PDF)

   1. Medicare payment for outpatient services under the Outpatient Prospective Payment System and the Physician Fee Schedule, inadequate Medicare physician pay and recent Medicare policy changes.

10. Physician-focused alternative payment models (PDF)

    1. Barriers in the current fee-for-service payment system, opportunities for physician-focused alternative payment models under MACRA and recommendations moving forward.

11. Reducing barriers to physician-focused payment models (PDF)

    1. Physician-focused payment models under MACRA and AMA strategies to address barriers to alternative payment models.

12. Hospice and palliative care (PDF)

    1. Hospice and palliative care programs and payment under Medicare.

13. Taking steps forward to cover the uninsured (PDF)

    1. Steps to make coverage more affordable to patients, improve the individual market risk pool, and stabilize and strengthen the individual market; benefits of improving the ACA vs. pursuing Medicare-for-all; and questions to consider with Medicare/Medicaid buy-ins and public options.

1. Equity in telehealth: Taking key steps forward (PDF)

   1. Ensuring equitable telehealth access by implementing telehealth solutions through partnerships with historically marginalized and minoritized populations and covering telehealth services by patients’ regular physicians.

2. Licensure & telehealth (PDF)

   1. Efforts to streamline the licensure process while supporting the state-based licensure structure.

3. State telehealth policies to ensure high-quality access to care (PDF)

   1. Guidance and policy solutions for lawmakers to support continued advancement of high-quality telehealth.

1. Protect access to physician-led care (PDF)

   1. The importance of physician-led health care teams, which are higher quality, lower cost and preferred by patients.

2. Physician-led care supports patient access to care (PDF)

   1. Evidence that allowing nurse practitioners to practice without supervision does not guarantee increased access to care in rural and underserved areas.

3. Physicians are trained to lead (Nurse practitioners) (PDF)

   1. Physicians, with the highest level of education and clinical training, are trained to lead the health care team. Learn how the education and training of physicians differs from that or nurse practitioners.

4. Physicians are trained to lead (Physician assistants) (PDF)

   1. Physicians, with the highest level of education and clinical training, are trained to lead the health care team. Learn how the education and training of physicians differs from that or physician assistants.

5. Access to care (PDF)

   1. Evidence that scope of practice expansion for nurse practitioners does not necessarily lead to more nurse practitioners in rural and underserved areas.

6. APRN multistate compact (PDF)

   1. Learn why the AMA opposes the APRM Compact, which unlike every other health professional compact, preempts state scope of practice laws.

7. Expanding nurse practitioner scope of practice leads to increased utilization of health care resources (PDF)

   1. Overview of studies that confirm scope expansions lead to increased costs from inappropriate prescribing, unnecessary referrals to specialists and unnecessary orders for diagnostic imaging.

8. Nurse anesthetists & truth in advertising: title misappropriation (PDF)

   1. AMA opposition to the use of the term “nurse anesthesiologists” by nurse anesthetists, which is misleading and goes against the AMA’s Truth in Advertising campaign.

9. Scope of practice: Summary of existing studies (PDF)

   1. Overview of findings from existing research on scope of practice.

10. Physician-led team-based care (PDF)

    1. High quality care, low costs and improved patient outcomes under physician-led team-based care.

11. Models of physician-led team-based care (PDF)

    1. Unique team-based models designed according to practice needs, population served and relevant state laws.

1. It is time to fix prior authorization (PDF)

   1. Patient harm and costs as a result of prior authorization, and prior authorization reforms for policymakers to consider.

2. Measuring progress in improving prior authorization (PDF)

   1. Results of the AMA’s 2021 physician survey on prior authorization, which reveal that prior authorization continues to harm patients and burden practices.

1. Confidential care to support physician health and wellness (PDF)

   1. Actions and policy recommendations designed to improve physician mental health and reduce physician burnout.

1. Modifier 25 (PDF)

   1. CPT guidelines for use of modifier 25, payer interpretation of modifier 25 and the key to challenging payer denials.

2. Privacy in retail health care settings (PDF)

   1. Challenges introduced by retail health organizations' privacy policies and consent practices.

1. AMA 2022 overdose epidemic national report (PDF)

   1. Current data showing actions physicians have taken combined with evidence-based solutions to end the nation’s drug-related overdose and death epidemic; improve care for patients with pain, mental illness or substance use disorder; and increase access to harm reduction services.

2. National snapshot of overdose epidemic (PDF)

   1. Select national, state and local news and reports detailing the scope of the nation’s drug overdose and death epidemic.

3. Recommendations of the AMA Substance Use and Pain Care Task Force (PDF)

   1. Recommendations urging physicians to take action to remove barriers to care, provide evidence-based care for patients with pain and those with substance use disorder and increase access to harm reduction services.

4. States must take action to enforce mental health and substance use disorder parity (PDF)

   1. State-level strategies to enforce compliance by health insurers with the Mental Health Parity and Addiction Equity Act.

1. 2022 and beyond: AMA’s plan to cover the uninsured (PDF)

   1. AMA’s plan to maximize health insurance coverage, increase affordability and improve the ACA.

2. Mitigating negative impacts of high-deductible health plans (PDF)

   1. Improving patient access to affordable care.

3. Improving health insurance affordability (PDF)

   1. Ensuring affordable and meaningful health care coverage for low- and moderate-income patients by making coverage more affordable for patients, improving the individual market risk pool and stabilizing and strengthening the individual market.

4. Promoting access to high-value care (PDF)

   1. Aligning clinical and financial incentives for high-value care to reduce barriers to affordable care.

5. Value-based insurance design (PDF)

   1. Encouraging high-value care through the alignment of patient and payer financial incentives under value-based insurance design.

6. Financing of long-term services & supports (PDF)

   1. Opportunities to alleviate the financial strain of long-term services and supports on Medicaid and families through public and private reform.

7. Using reinsurance to stabilize and strengthen the individual market (PDF)

   1. Using reinsurance to provide an equitable, fair and cost-effective mechanism to subsidize the costs of high-risk and high-cost patients and protect patients with preexisting conditions.

1. Price transparency (PDF)

   1. Resources and initiatives to overcome barriers to price transparency in order to lower health care costs and empower patients to choose low-cost, high-quality care.

2. No Surprises Act summary (PDF)

   1. Guide to surprise billing provisions in the Consolidated Appropriations Act.

3. No Surprises Act Final Rule summary (PDF)

   1. Summary of the Final Rules and accompanying documents issued by the Departments of Labor, Health and Human Services, and the Treasury addressing several provisions of the physician and provider payment process for out-of-network care under the No Surprises Act.

1. Improving drug price and cost transparency (PDF)

   1. Policy proposals for pharmaceutical companies, pharmacy benefit managers and health insurers to increase prescription drug price and cost transparency.

2. Prescription drug pricing and costs (PDF)

   1. Policy solutions to address rising prescription drug costs by increasing pharmaceutical market competition, combatting anticompetitive practices and requiring pharmaceutical supply chain transparency.

1. Hospital consolidation (PDF)

   1. Hospital acquisition of physician practices, promoting competition and choice in hospital markets, the role of states in market regulation and protection of hospital medical staff after mergers.

2. Improving physician communication during patient hospitalizations (PDF)

   1. Providing safe, high-quality and personal health care through timely and consistent communications among physicians during patient hospitalizations and the post-discharge period.

3. Payment & delivery in rural hospitals (PDF)

   1. Impact of payer mix, cost of delivering services, quality measurement challenges, risk adjustment challenges and strategies to improve rural hospitals’ viability and residents’ health.

1. Early disclosure and compensation programs (PDF)

   1. State legislative efforts in the implementation and expansion of communication and resolution programs.

2. Liability safe harbors for the practice of evidence-based medicine (PDF)

   1. AMA principles and policies to support states in implementing liability safe harbors for the practice of evidence-based medicine.

3. Constitutional challenges to state caps on non-economic damages (PDF)

   1. State-by-state overview of constitutional challenges to state caps on non-economic damages.

1. LGBTQ change efforts (so-called “conversion therapy”) (PDF)

   1. Negative health implications and ethical concerns of so-called “conversion therapy”.

2. Health insurance coverage for gender-affirming care of transgender patients (PDF)

   1. Improving health insurance coverage for medically necessary care to improve health outcomes for transgender individuals.

3. Transgender individuals’ access to public facilities (PDF)

   1. Mental and physical health implications of policies preventing transgender individuals from accessing public facilities consistent with gender identity.

1. Corporate practice of medicine (PDF)

   1. Overview of state laws and AMA resources on the corporate practice of medicine.

2. Physician self-referral (PDF)

   1. Comparison of state laws with federal statute and AMA policy on physician self-referral.

3. Certificate of need laws (PDF)

   1. Background on state certificate of need programs, which require individuals and entities in the health care industry to receive state regulatory approval before making a capital expenditure or constructing or expanding a facility or service.

4. Corporate investors (PDF)

   1. Potential risks and benefits of corporate investors on physicians, patients and health care prices.

1. Childhood poverty in the United States (PDF)

   1. Legislative update on the Child Tax Credit and child poverty as a public health issue.

2. Protecting the patient-physician relationship (PDF)

   1. Resources for confronting legislation that intrudes on ability of physicians to have open, frank and confidential communications with their patients.

3. Shackling of pregnant prisoners (PDF)

   1. Overview of AMA model legislation and policy condemning the shackling of pregnant prisoners during the birthing process.

4. Indoor tanning restrictions for minors (PDF)

   1. Opportunities for state lawmakers to improve the public health and safety of minors through the ban of the sale of ultraviolet rays (i.e., tanning sessions) to minors.

5. Addressing childhood obesity (PDF)

   1. Strategies for state policymakers to improve food environments and promote the consumption of healthy food and beverages in school.