Four policies recently adopted by the AMA

During the second day of voting at the annual American Medical Association meeting, physicians and medical student leaders adopted several new policies addressing key health care issues for the American public, the organization announced in a press release. The policies were discussed and voted upon by the AMA’s House of Delegates, which consists of physicians, medical students and residents across every state and medical specialty.

The latest House of Delegates voting session covered issues ranging from maternity care to physician identity theft. Four of the policies adopted by the AMA during the meeting are as follows:

1. A policy to crack down on physician identity theft.

Hundreds of doctors and other health professionals in at least 18 states have been the victims of tax fraud linked to identity theft and the filing of fraudulent federal income tax returns. This has resulted not only in loss of time and effort among physicians who must submit proof of identity and paper returns, it has also caused significant loss of revenue for the federal government. The AMA’s new policy requests that the Internal Revenue Service and CMS implement regulations prohibiting the use of social security numbers by insurers, vendors and government agencies to aid in the prevention of identity theft.

“Identity theft is one of the fastest-growing crimes nationwide, and the AMA is committed to taking bold steps to ensure physicians are protected,” incoming AMA board chair Barbara McAneny, MD, said in the release. “We believe the IRS should adopt policies that would assure greater security protection for electronically filed federal income tax returns, including the use of universal personal identification numbers that would help curb the incidence of identity theft and the filing of fraudulent federal income tax returns.”

2. A policy banning smoking in cars when accompanied by minors.

Children are often the main victims of secondhand smoke, and are more susceptible than adults to its potential damage, including risk for ear disease, lower respiratory infections and asthma. The AMA’s expanded secondhand smoke policy supports legislation to ban smoking while operating or riding in a car with children.

“The dangers of second-hand smoke are marked and proven, and no one is more at risk than our youth,” William Kobler, MD, member of the AMA board of trustees, said in the release. “It is important that we do all that we can to reduce exposure to secondhand smoke by supporting smoke-free environments, including vehicles.”

3. A policy to address concerns about CMS hospital observation rules.

Although the use of “observation status” for hospital patients may be useful for cutting costs, some physicians are concerned that it may also reduce the quality of care. According to the release, patients in observation status often require the same services as inpatients, and can incur lengthy hospital stays. In 2012, there were a reported 1.5 million observation stays among Medicare beneficiaries, with more than 92% of these patients spending a night or longer in the hospital. This can place a significant financial burden on patients who are unaware of their observational status. Additionally, patients on observation status may receive little or no planning for their discharge, which can lead to serious safety issues. The AMA’s new policy urges further public education and resources for physicians and patients regarding this issue.

“We have an obligation to ensure patients are receiving the right care, at the right time, in the right setting and at the right cost,” AMA Board Member Albert Osbahr, MD, said in the release. “This new AMA policy seeks to ensure CMS develops payment solutions that address the inappropriate use of hospital observation status in order to curb unnecessary costs and better serve patients.”

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4. A policy to expand maternity care coverage for young women under the ACA.

Under the Affordable Care Act, young adults can retain coverage through their parents’ health insurance policies until the age of 26. Based on 2013 data indicating the average age of first pregnancy as 25.7 years, this could signify an increased number of female dependents becoming pregnant while covered under their parents’ plan. With the average cost of care for a vaginal delivery estimated at more than $32,000, young women who become pregnant in this situation may struggle with less than full coverage as dependents. To prevent this potential gap in coverage, the AMA’s new policy petitions large group health plans to expand maternity care coverage to dependents aged under 26 years who are covered under their parents’ plans. Additionally, the policy calls for 60 days of newborn coverage for all babies born to dependent mothers aged under 26 years.

"Dependent coverage without maternity care benefits is incomplete and could impose substantial costs on young mothers and their parents," Osbahr said in the release. "This policy is consistent with existing AMA policy, which encourages comprehensive maternity coverage for all women, and health insurance coverage for the care of newborns from the moment of birth."