Last Updated: Jun 24, 2021

The Pennsylvania Medical Society’s delegation to the American Medical Association (AMA) dedicated their time and expertise at the recent Special Meeting of the AMA House of Delegates (HOD), held virtually June 11-16, 2021, to discuss important health care issues such as scope of practice, health plan practices, COVID-19, telemedicine, diversity in medicine, and more.

Pennsylvania delegation members were successfully led by delegation Chair Scott Shapiro, MD and Vice Chair Jill Owens, MD. Delegation physicians active in AMA leadership positions at the meeting include Marilyn Heine, MD, Chair of the AMA Council on Legislation; John Williams, MD, Member of the AMA Council on Medical Education; James Goodyear, MD, Member of the AMA Council on Long Range Planning and Development; Dale Mandel, MD, Member of the Reference Committee on Medical Service; and PAMED President Michael DellaVecchia, MD, PhD, Member of the Reference Committee on Science and Technology.

"The AMA influences policymakers nationally and aids advocacy at the state level," said Dr. Heine. "As members of the AMA House of Delegates, PAMED physicians and medical students impact policy that affect our patients, practices, and public health in Pennsylvania and nationwide."

Highlights of actions taken at the AMA HOD include:

Scope of Practice

• Adopted policy strongly opposing the American Academy of Physician Assistants’ (AAPA) move to change the official title of the profession from ‘physician assistant’ to ‘physician associate; PAMED also strongly opposes this title change. Delegates widely acknowledged that physician assistants remain an important part of the health care team but that changing their name to ‘physician associates’ will only confuse patients.
  
  
• Referred a proposal regarding confusion over the use of terms “residency” and “fellowship” in nonphysician graduate programs for more study.
  
  

Private Payer Issues

• Adopted new policies addressing peer-to-peer prior authorization that call for those approvals to be made actionable within 24 hours of the discussion, and require that the reviewing physician have clinical expertise to treat the medical condition or disease under review.
  
  
• Directed the AMA to advocate against payer efforts to eliminate incident-billing among private and public payers.
  
  
• Asked the AMA to study a proposal to lower the Medicare eligibility age from 65 to 60.
  
  

Telemedicine

• Adopted a series of policies aimed at continuing the use of telehealth beyond the pandemic, while addressing issues related to state medical licensure, regulation, payment, and equitable access.
  
  
• Referred a proposal to the AMA Board of Trustees for decision that calls for the AMA to work with the Federation of State Medical Boards, state medical associations, and other stakeholders “to encourage states to allow an out-of-state physician to use telehealth to provide continuity of care to an existing patient in the state without penalty” if certain liability, HIPAA, and other conditions are met. 
  
  
• Directed the AMA to conduct or commission a study on the effects that telemedicine services have had on health insurance premiums, focusing on the differences between states that had telehealth payment parity provisions in effect prior to the pandemic versus those that did not, and report back at AMA’s November 2021 Interim Meeting.
  

PAMED supports telemedicine legislation in Pennsylvania (Senate Bill 705) that seeks to define telemedicine, offer guidelines outlining who can provide telemedicine services, and provide clarity around insurance company reimbursement for telemedicine services.

COVID-19

• Endorsed guidelines for vaccine mandates and credentials
  
  
• Voted to support the development of diagnostic codes to recognize post-acute sequelae of SARS-CoV-2 infection (“PASC 14” or “long COVID”) as a distinct diagnosis; advocate for legislation to provide funding for research, prevention, control, and treatment; and provide physicians and medical students with accurate and up-to-date information.
  
  
• Voted to work with the Accreditation Council for Graduate Medical Education and other stakeholders to ensure residents and fellows whose training was interrupted by the pandemic, or who may have been redeployed to other specialty areas, get the support they need to qualify for graduation and board eligibility.
  
  
• Referred for more study a separate education measure on ways to reduce financial burdens on trainees when it comes to covering costs for meals, uniforms, and childcare.
  
  

Diversity

• Adopted broad workplace guidelines that address systemic racism in medicine, including discrimination, bias, and abuse. In a statement, that AMA said that it will recommend that “health care organizations and systems use the new guidelines to establish institutional policies that promote positive cultural change and ensure a safe, discrimination-free work environment.”
  

Check out more on PAMED’s culture of diversity, equity, and inclusion, including our Health Diversity Task Force.