After helping state medical associations and national specialty societies defeat more than 100 bills to inappropriately expand nonphysicians’ scope of practice in 2023, the AMA is again relentlessly joining its allies in organized medicine to continue the fight for physician-led, team-based care in this year’s legislative session.

This intensive and effective advocacy effort has ranged across the country, as the AMA has helped battle scope creep in Alaska, Connecticut, Georgia, Oklahoma, New Hampshire and elsewhere.

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After a routine review of practice operations in mid-February, Omar Maniya, MD, opted to extend the line of credit for the 40-employee New Jersey primary care physician practice that he serves as CEO.

Little did he know the move would prove to be a just-in-time lifeline as within days the cyberattack-driven Change Healthcare cyber outage would have a devastating financial impact on physician practices across the country. At Dr. Maniya’s practice, called Maniya Health, “95% of our revenue vanished overnight,” forcing the practice to borrow nearly $200,000 to keep things going.

“We’ve never used our line of credit—ever—until this,” said Dr. Maniya, who trained as an emergency physician and provides urgent care three days a week for the practice in addition to his executive role. “Having that cushion is what allowed us to survive the storm without having to lay off or furlough employees.”

Maniya Health has had to reschedule iron-infusion appointments and reexamine its supply-ordering, and it is far from alone in feeling the effects of the cyber outage, as informal AMA survey findings (PDF) show. According to the survey, conducted March 26–April 3 with a convenience sample of 1,400 respondents, restricted claims-processing functionality since the cyberattack has resulted in:

• 36% of respondents reporting suspension in claim payment.
• 32% being unable to submit claims.
• 22% being unable to verify eligibility for benefits.

Practices of 10 physicians or fewer appear to be particularly hard hit. They represented 78% of all respondents.

The survey was conducted after UnitedHealth Group, which owns Change Healthcare, said that claims would be flowing by the weekend of March 23. Despite the company’s assurances, serious disruptions continue.

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The Biden administration has recently taken some positive steps to help more Americans gain access to high-quality health insurance coverage.

First is a newly finalized rule governing short-term, limited-duration insurance that closes loopholes and protects people from misleading marketing tactics by requiring health insurers to be up front with consumers about coverage so they can better distinguish such plans from more comprehensive coverage.

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The AMA is the physician’s relentless and powerful ally in health care, and unprecedented times require bold action. Physicians face far too many challenges that interfere with patient care.

That’s why the AMA is advocating to keep doctors at the head of the health care team, reform the Medicare physician payment system, relieve the burden of overused prior authorizations and so much more.

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The U.S. drug-overdose and death epidemic continues to kill more than 100,000 people a year and demands immediate and collective action.

“As a nation, we have to do better,” AMA President Jesse M. Ehrenfeld, MD, MPH, noted in a Leadership Viewpoints column last year. “As physicians, we must show the leadership necessary to make a difference.”

At the individual level, such leadership can include becoming familiar with evidence-based, practical insights to address the opioid-overdose epidemic. The AMA has created a seven-episode podcast series that serves up just that, with each episode being enduring material that is designated by the AMA for PRA Category 1 Credit.

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The time-wasting, care-delaying payer cost-control process known as prior authorization is the bane of physicians’ existence.

According to the most recent AMA survey (PDF) of 1,001 practicing physicians, 89% of respondents said prior authorization had a significant or somewhat negative clinical impact, with 33% reporting that prior authorization had led to a serious adverse event such as a death, hospitalization, disability or permanent bodily damage, or other life-threatening event for a patient in their care. …

As the physician’s powerful, relentless ally in health care, the AMA’s hard work to ease the burdens of prior authorization is starting to pay off. There is a long way to go yet, but below you will find some positive signs of progress in the AMA’s long-standing, focused effort to fix prior authorization.

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Telehealth use exploded to play an outsized role in helping patients safely access care when the COVID-19 pandemic first hit four years ago, but it is wrong to think of this form of digitally enabled care as a relic of 2020. Indeed, 74% of physicians work in practices that offer telehealth.

Rather, it seems as though every day offers more evidence of how telehealth can help improve access to care, save lives and advance the quality of care in a wide array of physician specialties and clinical conditions.

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The most widely circulated general medical journal in the world is launching a series on the health impact of climate change.

The series from JAMA “is intended to stimulate improved knowledge and understanding of the health effects of climate change to help foster commitment to timely action to prevent adverse health events from climate change,” says an introductory “JAMA Insights” article.

“Action and leadership should begin now to improve resilience in health systems and minimize the contribution of medical practice to climate change. Sustained and meaningful investment to reduce climate change and mitigate its effect on health are needed. Without this, adverse health consequences of climate change will continue to increase,” says the article, written by Kristie L. Ebi, PhD, and Jeremy J. Hess, MD, MPH, of the University of Washington Center for Health and Global Environment in Seattle. In addition to writing the first article in the series, Ebi and Dr. Hess will serve as guest editors to further develop it.

The JAMA series is part of a wider movement in medicine to understand climate change’s health impact and take action to address it.

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The Centers for Medicare & Medicaid Services today announced a program of accelerated payments to Medicare Part A providers and advance payments to Part B providers to help stem the immense financial fallout of the February cyberattack on the claims-processing systems of Change Healthcare, a subisidiary of UnitedHealth Group.

The move comes in the wake of forceful advocacy from the AMA calling for additional relief for physicians given the estimated $100 million daily impact of the outage on the health care industry.

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The Department of Health and Human Services is responding to pleas from the AMA and others for regulatory flexibility to help ease the major disruptions in claims processing and payment linked to the cyber outage at UnitedHealth Group subsidiary Change Healthcare. While the AMA appreciates the flexibilities that HHS and the Centers for Medicare & Medicaid Services announced, the administration needs to go further to provide relief for physicians.

“Many physician practices operate on thin margins, and we are especially concerned about the impact on small and/or rural practices, as well as those that care for the underserved,” said AMA President Jesse M. Ehrenfeld, MD, MPH. “The AMA urges federal officials to go above and beyond what has been put in place and include financial assistance such as advanced payments for physicians.”

The cybersecurity-linked outage is costing the health care industry an estimated $100 million a day.

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The U.S. Congress has again failed to stop in its entirety a pay cut that will threaten Medicare patients’ access to high-quality physician care.

In a federal budget deal struck to continue operating the government, the House of Representatives has voted to reduce by about half—1.68%—of the 2024 3.37% across-the-board physician pay cut that took effect in January. The Senate is expected to vote for the deal Thursday, and the new pay rate starts March 9.

The cut comes on top of last year’s 2% Medicare physician pay reduction, and the new payment rate is not retroactive.

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The nation’s worsening opioid-overdose epidemic has prompted the AMA to call for the elimination of dose-limit barriers to ensure adequate buprenorphine treatment for patients with opioid use disorder.

Now, patients and physicians encounter strict dose limits set by health insurers and other payers based on drug labels approved by the Food and Drug Administration decades ago, when illicitly manufactured fentanyl and fentanyl analogues were not a major cause of mortality as it is today. Buprenorphine reduces the risk of fatal overdose, eases opioid withdrawal symptoms and cravings, and helps sustain recovery for patients with an opioid-use disorder.

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The AMA and more than 120 other national medical organizations and state medical societies last week called on Congress to pass legislation to reverse the 3.37% Medicare physician pay cuts that took effect Jan. 1.

But Congress kicked the can down the road, passing a continuing resolution (CR) that funds four appropriations bills through March 1 and the other eight through March 8 to avoid a government shutdown. While that CR did delay cuts to safety-net hospitals, community health centers and more, it did not reverse the physician pay cut—a clear disservice to the country’s Medicare patients and the doctors who care for them.

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