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November 15, 2016

Topics of Interest from the AMA House of Delegates Interim Meeting

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Anti-HCG Position Statement

Ethan Lazarus Testifying at AMA House of Delegates MeetingDr. Lazarus: During a presentation by the Council on Science and Public Health about compounded hormone preparations, I introduced a recommendation that “the AMA establish a position that the use of human chorionic gonadotropin (HCG) for weight loss is inappropriate.” The recommendation received support from delegates from Colorado, Nevada, and Reproductive Medicine, and after debate on the floor, the AMA accepted this as a new policy statement. This policy is consistent with OMA’s position statement on the use of HCG for weight loss. Read the full press release from OMA applauding the AMA’s adoption of this policy.

Obesity Caucus

Dr. Lazarus: OMA hosted the obesity caucus again at the meeting. The caucus announced in the Speaker’s Letter, which is given to all AMA delegates at the introduction to the meeting. The room was packed with more than 25 attendees from various state and specialty societies. Those present discussed obesity education initiatives, strategies to improve obesity parity, and the current status of the Treat and Reduce Obesity Act (which, if you recall, the AMA has officially endorsed). In addition, those at the caucus discussed multiple ideas for resolutions to improve obesity care. The caucus plans to introduce policy in upcoming AMA meetings. Dr. Lazarus agreed to spearhead the resolution development with this newly evolving obesity coalition.

Dr. Francavilla: The obesity caucus continues to grow and become more productive. Twenty-five people from a variety of specialties and geographic locations attended. This was a great way to highlight our organization and specialty. Many of those in attendance were excited to hear about our Obesity Algorithm! It was a very productive meeting with interest in working on a resolution regarding people-first language and de-stigmatization of obesity, as well as promoting technology to improve obesity treatment, and asking the AMA to create an obesity toolkit for providers.

Additional Items of Interest

Dr. Lazarus: Nearly 100 resolutions and reports were discussed. One resolution called for addressing discriminatory health plan exclusions in the Affordable Care Act. I testified on behalf of OMA in support of this resolution, pointing out that obesity has been recognized as a disease by the AMA, yet health plans routinely deny access to all evidence-based prevention, counseling, and treatment options. I also reminded the audience that extreme obesity disproportionately affects women and minorities, so with regards to obesity, discriminatory plan design that fails to cover obesity care services further represents discrimination against these groups. The AMA passed this resolution calling for an end to these discriminatory health plan exclusions.

Dr. Francavilla: The AMA House of Delegates interim meeting primarily focused on advocacy issues. Some of the topics most relevant to OMA were:

  • Medical Necessity of Breast Reconstruction Reduction Surgery: This passed policy supported using evidence-based and clinical criteria to provide appropriate care and eliminate requirements of weight or volume resected during breast-reduction surgery. I testified on behalf of this policy as this is an issue the affects many patients with obesity.
  • Product-specific Direct-to-consumer Advertising of Prescription Drugs: This was a very thoughtfully written report supporting a ban of product-specific direct-to-consumer advertising—which is banned in almost all countries—and included excellent recommendations on how to best proceed until such a ban may occur.
  • Addressing Discriminatory Health Plan Exclusions or Problematic Benefit Substitutions for Essential Health Benefits under the Affordable Care Act: This passed policy encouraged the AMA to work with state medical societies and federal regulators to deal with discriminatory health plan exclusions. Dr. Lazarus spoke in favor of this issue and pointed out that treatment of obesity is heavily affected by these discriminatory policies. This issue is something the OMA’s advocacy committee has been working on, and this new policy should allow us to help leverage the AMA’s support to further OMA’s initiative to eliminate discriminatory benefit design in regards to obesity.
  • MACRA: The AMA showed their commitment to helping physicians understand the new medicare payment models under MACRA. The AMA has successfully advocated to try to make MACRA as beneficial as possible for physicians. For any providers taking Medicare, the AMA has and will continue to have additional tools to help physicians navigate this new system. I actively participated in the forum on this matter.

Young Physician Section

Dr. Francavilla: I represented OMA to the Young Physician Section (YPS) of the AMA. The Young Physician Section’s main objectives at this meeting were to advocate for continuing the provisions of the ACA in light of the recent election, covering fertility treatment, and advocating for equality.