DEC 01, 2022
Academy Supports AMA Policies on Interpreters, Drug Prescribing, OR Waste
The Academy supported efforts to increase reimbursement, protect physician autonomy in drug prescribing and reduce operating room waste at the recent House of Delegates meeting of the American Medical Association.
The AMA considers many resolutions at this annual meeting. Here are the three most noteworthy for ophthalmology that were approved by the House of Delegates.
Delegates approved a resolution (PDF) urging the AMA to push for reimbursement of interpreter services. They also approved an Academy-submitted amendment to include American sign language in the list of costs.
Under antidiscrimination laws like the Civil Rights Act of 1964, patients have a right to interpreter services. However, almost no health plans reimburse the physician for it. California requires health plans to provide interpreters at hospitals.
Medicaid does allow for a 50% reimbursement, but only some states take advantage of that. According to a report (PDF) that helped guide development of California’s policy, states take different approaches to covering interpretation:
- Montana, New Hampshire and Wyoming pay interpreters, so physicians can focus on treatment.
- Idaho, Iowa, Maine and Minnesota reimburse providers for hiring interpreters.
- Other states and Washington, D.C., contract with language service agencies.
Medicare has yet to cover interpretation. As the AMA resolution notes, interpreter services can cost up to $150 an hour. That cost can eat up most of the physician fee for the service.
Third-Party Pharmacy Benefit Administrators
These organizations play an increasing role in trying to reduce costs for health plans. As AMA’s resolution noted, “third-party administrators use heavy-handed tactics with physicians and patients to force the use of preferred prescriptions, with little transparency and opaque practices.”
These practices can significantly interfere with your ability to choose the best treatment for your patients.
Despite the similarity to pharmacy benefit managers, third-party administrators operate with little regulation. The Academy co-sponsored the AMA resolution (PDF), which calls for state and federal regulations to include third-party administrators in their oversight of pharmacy benefit managers.
In keeping with the Academy’s leadership on reducing drug waste, we also supported a resolution titled “Promoting the Use of Multi-Use Devices and Sustainable Practices in the Operating Room.”
Having formal AMA policies on record bolsters our efforts to advocate on issues at the state and federal level.