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The 2012 Interim Meeting of the American Medical Association’s just concluded, and once again, neurosurgery’s small, but mighty, delegation made its mark.  In recognition of his longstanding service to his patients and the profession, the AMA honored one of neurosurgery’s own – Dr. Mark J. Kubala – with its Distinguished Service Award.  In addition, the AMA House of Delegates considered several key reports and resolution of interest to neurosurgery on such topics as Medicare reform, sequestration budget cuts, ICD-10 coding, Medicare quality and resource reports, electronic health records, and expanding Medicaid eligibility.  Below is a brief overview of the actions taken on these key topics.

  • Strengthening Medicare for Current and Future Generations.  The House of Delegates unanimously adopted policy (in line with neurosurgery’s own views) calling for the modernization of Medicare from a defined benefit to a defined contribution program.  Such a program would enable beneficiaries to purchase coverage of their choice from among competing health insurance plans, while preserving traditional Medicare as one option.  The government’s contribution should vary based on beneficiary age, income and health status, with lower income and sicker beneficiaries receiving larger contributions.  Any efforts to strengthen the Medicare program must also ensure that mechanisms are in place for financing graduate medical education to ensure an adequate supply of physicians to care for all Americas.  Additionally, the AMA reaffirmed its policies supporting Medicare private contracting and balance billing.
  • Sequestration Budget Cuts.  Emerging from its meeting, the AMA will be urging Congress to develop a fiscally responsible alternative that would prevent the automatic budget sequestration cuts that would endanger critical programs related to medical research, public health, workforce, food and drug safety, and healthcare for uniformed service members, as well as trigger cuts in Medicare payments to graduate medical education programs, hospitals, and physicians that will endanger access to care and training of physicians.
  • Eliminating ICD-10.  Physicians attending the meeting passionately expressed their belief that implementation of the new ICD-10 coding system will create unnecessary and significant financial and workflow disruptions for physicians, especially at a time when physicians are in various stages of trying to implement electronic health records into their practices.  The House of Delegates therefore voted to “vigorously advocate that the Centers for Medicare & Medicaid Services eliminate the implementation of ICD-10.”  The AMA will immediately reiterate to CMS and Congress that the burdens imposed by ICD-10 will force many physicians in small practices out of business.
  • Medicare Quality and Resource Use Reports.  Recognizing the many flaws with Medicare’s current Quality and Resource Use Reports (QRURs), the House of Delegates voted to continue to work with CMS to improve the design, content, and performance indicators included in the physician QRURs, so that the reports reflect the quality and cost data associated with calculating the Value-Based Payment Modifier (VBPM).  Moreover, the AMA will continue to seek to delay implementation of the VBPM program.
  • Medicare Penalties for Non-Adoption of EHR.  The AMA reaffirmed its existing policy, strongly expressing that penalties should be removed from Medicare’s electronic health record (EHR) programs, positive incentives are needed, and funds should be provided to physicians to cover all costs of implementation and maintenance of EHR systems.
  • Medicaid Expansion.  If asked by a state medical society, the AMA will work with state and specialty medical societies to advocate at the state level to expand Medicaid eligibility to 133% of the Federal Poverty Level as authorized by the Affordable Care Act.

Full details are available at the AMA’s website at:

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