Texas Influences a Dozen AMA Policies
By Pam Udall

Texas made its presence known in Chicago when the Texas Delegation to the American Medical Association arrived to advocate for stronger action to fix physicians’ Medicare payments once and for all, health plan accountability, and vigilance on scope creep in emergency departments.   

These were among the dozen resolutions the Texas Delegation brought to the Annual Meeting of the AMA House of Delegates in mid-June “and all 12 were adopted in some form or fashion,” said David Henkes, MD, delegation chair. “Texas once again led the charge to ensure AMA made improving physicians’ Medicare payments a top legislative priority.”   

Texas Medical Association members also won key AMA leadership positions.  

The AMA house agreed with Texas by unanimously adopting its call for AMA to increase media awareness about the need for Medicare payment reform, eliminating budget neutrality reductions, and instituting cost-of-living increases. Texas also asked AMA to set up a public relations campaign to get more buy-in from the public about the need for Medicare payment reform, and to advocate for the abolition of all Merit-Based Incentive Payment System penalties considering the current inadequate Medicare payments.   

“Physicians from across the nation rallied with Texas to encourage AMA to put more money and time behind this dire issue that continues to push physicians out of the health care system,” said Dr. Henkes.  

Also on payment, TMA President G. Ray Callas, MD, participated in a panel discussion to explain why automatic downcoding of claims by health plans must stop, with the AMA house adopting Texas’ resolution to:   

• Oppose health plans exclusively relying on software, algorithms, or other methodologies to deny or downcode evaluation and management services; 
• Support better transparency by health plans if they downcode claims (EOB or other claims adjudication); and  
• Advocate for legislation to provide transparency and prohibit automated denials.   

Texas also stood firmly behind efforts to ensure emergency departments (EDs) are physician-led.   

“We just can’t have emergency departments staffed only with advanced practice registered nurses. EDs must be physician-led to ensure the highest level of quality care,” Dr. Callas testified during a reference committee hearing on legislation-related initiatives.  

The AMA house also took up several resolutions, including one from Texas, to address different aspects of artificial intelligence use in health care. AMA delegates ultimately voted to combine the resolutions and immediately create an Artificial Intelligence Task Force to evaluate and guide medicine on the new technology.   

Other Texas resolutions that won support direct AMA to:  

• Advocate for increased insurance coverage for follow-up testing after abnormal screening mammography. 
• Call for increased insurance coverage for gynecologic oncology care. 
• Advocate (through legislation and/or regulation, as appropriate) for adequate payment and the elimination of cost-sharing in all health plans for the full range of colorectal cancer screening and all associated costs, including colonoscopy with a “diagnostic” intervention (i.e., the removal of a polyp or biopsy of a mass) and follow-up colonoscopy after a positive stool-based test. 
• Develop model legislation to protect patients managed by out-of-network physicians by prohibiting insurance plans from denying payment for covered services, based solely on the network participation of the ordering physician, and to develop resources, toolkits, and education to support out-of-network care models.  
• Advocate for federal legislation requiring that health benefit plans may not charge any form of cost sharing for covered prostate cancer screening.  
• Sustain funding for Health Resources Services and Administration (HRSA) 340-B grant-funded programs. 
• Support the United States Consumer Product Safety Commission in implementing higher safety standards for consumer products that produce carbon monoxide and support public education efforts to minimize harm caused by carbon monoxide poisoning produced in enclosed spaces or too close to exterior openings.  
• Adopt greater standardization of the AMA endorsement process.