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REPORT OF THE BOARD OF TRUSTEESB of T Report 23-A-09Subject:Council on Legislation Sunset Review of 1998 and 1999 House PoliciesPresented by:Joseph M. Heyman, MD, Chair Referred to:Reference Committee B(Monica C. Wehby, MD, Chair)At its 1984 Interim Meeting, the House of Delegates established a sunset mechanism for House policies (Policy G-600.110, AMA Policy Database). Under this mechanism, a policy established by the House ceases to be viable after 10 years unless action is taken by the House to retain it.The objective of the sunset mechanism is to help ensure that the AMA Policy Database is current,coherent, and relevant. By eliminating outmoded, duplicative, and inconsistent policies, the sunsetmechanism contributes to the ability of the AMA to communicate and promote its policy positions.It also contributes to the efficiency and effectiveness of House of Delegates deliberations.At its 2002 Annual Meeting, the House modified Policy G-600.110 to change the process throughwhich the policy sunset review is conducted. The process now includes the following steps:
In the spring of each year, the House policies that are subject to review under the policy sunsetmechanism are identified.
Using the areas of expertise of the AMA Councils as a guide, the staffs of the AMA Councilsdetermine which policies should be reviewed by which Councils.
For the Annual Meeting of the House, each Council develops a separate policy sunset reportthat recommends how each policy assigned to it should be handled. For each policy it reviews,a Council may recommend one of the following actions: (a) retain the policy; (b) rescind the policy; or (c) retain part of the policy. A justification must be provided for the recommendedaction on each policy.
The Speakers assign the policy sunset reports for consideration by the appropriate ReferenceCommittees.Although the policy sunset review mechanism may not be used to change the meaning of AMA policies, minor editorial changes can be accomplished through the sunset review process.In this report, the Board of Trustees presents the Council on Legislation’s recommendations on thedisposition of the House policies that were assigned to it. The Council on Legislation’srecommendations on policies are presented in the Appendix to this report.RECOMMENDATIONThe Board of Trustees recommends that the House of Delegates policies listed in the Appendix tothis report be acted upon in the manner indicated and the remainder of this report be filed.
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APPENDIX - RECOMMENDED ACTIONS ON 1998 HOUSE POLICIES
Policy Number TitleTextRecommendationH-15.955Restrictions on NewAdolescent Drivers – Development of Model StateLegislation onGraduated DrivingLawsOur AMA, recognizing the developmental driving issues that continueto threaten the lives of adolescents, will strengthen our model statelegislation on graduated driver’s licenses to: (1) require adolescents toobtain a provisional driving license (separate from a learner’s permit);(2) require experience adult supervision for adolescent drivers duringthe provisional driving period; and (3) limit the number of passengersin vehicles driven by adolescents during the provisional driving period.(Res. 408, A-99)Rescind – The policy beingadvocated is no longer necessary asa model bill that includesrecommendations from policy has been adopted.H-15.999Automobile SafetyStandardsThe AMA supports proper legislation to establish safety standards for automobiles and will continue to offer to government, industry, andother interested parties its advice and consultation on the medicalaspects of automotive safety. (Sub. Res. 36, A-66; Reaffirmed: CLRPDRep. C, A-88; Reaffirmed: Sunset Report, I-98)RetainH-30.977 Alcoholism as aDiseaseThe AMA urges change in federal laws and regulations to require thatthe Veterans Administration determine benefits eligibility on the basisthat alcoholism is a disease (Res. 112, A-88, I-98)RetainH-35.976Channeling of EyeExaminations toOptometristsThe AMA issue a letter to all third party payers stating organizedmedicine’s strong opposition to: (a) channeling enrollees tooptometrists and other non-physicians; (b) designating optometrists as primary eye care providers; (c) shifting patients from ophthalmologiststo optometrists; and (d) excluding ophthalmologists from performingrefractive eye examinations, routine eye examinations, or primary eyecare. The AMA, state medical societies, and national medical specialtysocieties seek introduction of legislation prohibiting third party payersfrom mandating that routine and refractive examinations be performed by optometrists rather than by ophthalmologists. (Res. 213, A-98)Retain
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H-35.977Rescission of theBalanced Budget ActProvision on NursePractitioner Paymentand BillingEnhancementsOur AMA supports the introduction of legislation that would rescindSection 4511 of the Balanced Budget Act of 1997 which enables NursePractitioners and Clinical Nurse Specialists to be paid directly (Res.211, A-98)Rescind – The policy beingadvocated is comprehensively dealtwith in the following statement: H-360.988, Nurse Practitioner Reimbursement Under Medicare.H-65.980Support of HateCrimes PreventionLegislationOur AMA: (1) recognizes that hate crimes pose a significant threat tothe public health and social welfare of the citizens of the United States;(2) urges expedient passage of appropriate hate crimes preventionlegislation in accordance with AMA policy H-65.992 through letters tomembers of Congress; and (3) registers support for hate crimes prevention legislation, via letter, with the President of the UnitedStates. (Res. 228, I-98)RetainH-65.982Texas HopwoodDecisionThe AMA supports the position of the state of Texas in appeals of theHopwood decision (Res. 323, A-96, Res. 328, A-98)Rescind – The U.S. Supreme Courtdecided this case in 2003.H-70.957DiagnosisInformation andLaboratory TestPanelsThe AMA: (1) strongly objects to, and will consider legal injunctiverelief against, the Department of Health and Human Services Office of the Inspector General's (OIG) model compliance plan for clinicallaboratories and Centers for Medicare & Medicaid Services (CMS)Medicare policies that have led laboratories to require an "acceptable"diagnosis for each laboratory test ordered by physicians; and (2) urgesCMS to prohibit Medicare carriers from routinely requiring thatlaboratories submit diagnosis information for laboratory tests that areindividually ordered by physicians. (CMS Rep. 11, A-97; Reaffirmed by CMS Rep. 7, A-98; Reaffirmation A-99)Rescind – The AMA was a party tothe negotiated rule-making processthat determined what lab testswould be covered with specifieddiagnosis codes.H-85.963Medicare HospiceBenefitOur AMA will seek amendment of the Medicare law to eliminate thesix-month prognosis under the Medicare Hospice benefit and supportidentification of alternative criteria meanwhile supporting extension of the prognosis requirement from 6 to 12 months as an interim measure.(Res. 101, A-99)Retain
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