Practice Economics

AMA HOD: Delegates back ICD-10 reprieve, but gun proposals draw fire




CHICAGO – Physicians would have a 2-year reprieve from penalties while using the new ICD-10 coding set, under a resolution easily passed June 8 by the American Medical Association’s House of Delegates.

However, two proposals related to gun violence generated more heat than consensus among the AMA delegates at their annual meeting.

The ICD-10 resolution calls for the AMA to push the Centers for Medicare & Medicaid Services and other payers for a 2-year grace period from penalties physicians would otherwise face due to coding errors, mistakes, or other issues that might arise after the Oct. 1, 2015, transition to the new coding set.

The resolution passed without any discussion, other than a request that its reference committee report be considered at the top of the voting agenda so the AMA could begin working on it immediately.

The rest of the ICD-10 resolution calls for the AMA to educate physicians on how to meet obligations to Medicare and private payers if they choose to become a cash-only practice that no longer accepts insurance. The resolution also calls for the AMA to collect data on how ICD-10 implementation affects patients and changes practice patterns.

In contrast, two resolutions on gun-related violence produced far less agreement among the delegates.

The first resolution addressed prevention of firearm-related injuries and deaths among youth by calling on the AMA to work with other organizations to identify materials that could be handed out as educational material in clinical practice.

Some delegates were concerned that the resolution could open the door to partnerships with organizations such as the National Rifle Association. However, others saw that as a good thing, because it could open the door to the organizations working together and finding common ground. Some delegates also noted that the NRA has the ability to reach people to promote gun safety whom the AMA might not be able to reach.

After discussion, delegates passed the resolution with a voice vote.

Delegates also considered a resolution in favor of background checks for gun purchases. An earlier AMA Board of Trustees report recommended support for background checks for anyone buying firearms.

A number of delegates rose in support of this proposal. Speaking on behalf of the American Academy of Family Physicians, AAFP President Dr. Robert L. Wergin noted the recent statement of support signed by a number of medical societies and the American Bar Association.

However, the background-check provision met resistance. Some delegates said it would not do anything to stop criminals who are obtaining guns illegally, while others said it was too far-reaching to require all sales to be accompanied with a criminal background check.

The proposal does not address those who can legally own guns, such as law enforcement officials and those who recently purchased a gun and already underwent a check, cautioned Dr. Michael Greene, of Macon, Ga. Others mentioned the potential impact on situations such as nonoperative weapons that are transferred as heirlooms, as well as guns given as gifts.

In the end, delegates sent the resolution back to committee for further consideration.

Delegates did approve an electronic health records resolution that called for holding vendors accountable for system downtime and other technology disruptions, and working with the CMS to earn physicians partial credit if some meaningful use objectives are met, rather than the current all-or-none situation.

Delegates also approved provisions to increase the use of prescription drug monitoring programs (PDMP). Under those provisions, the AMA would support voluntary use of state PDMP programs, encourage states to modernize their programs, and support allowing access to PDMPs by a delegate appointed by a physician.

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