The American Medical Association (AMA), the premier national physician organization in the country, voted to adopt new policies related to veterans health and patient access to prescriptions on the second day of its Annual Meeting.
The AMA's House of Delegates is the policy-making body at the center of American medicine, bringing together an inclusive group of physicians, medical students and residents representing every state and medical field. Delegates work in a democratic process to create a national physician consensus on emerging issues in public health, science, ethics, business and government to continually provide safer, higher quality and more efficient care for patients and communities.
The policies adopted by the House of Delegates today include:
More Choices for Veterans Care
The AMA approved policy encouraging the U.S. Department of Veterans Affairs (VA) to continue enhancing and developing alternative approaches for veterans to seek care outside the established VA system if the department cannot provide adequate or timely care. The delegates urged the VA to develop criteria by which individual veterans may request alternative pathways. The AMA also will continue supporting the Veterans Choice Program (VCP) and urged lawmakers to make it permanent. The VA should use external assessments as necessary to identify and address systemic barriers to care.
"The VCP was an admission that additional mechanisms were necessary to ensure veterans have timely access to the health care they need. Not all of our veterans live near VA facilities, and accommodations should be made to ensure they get the care they earned and deserve. The VA has focused on improving the care it provides to veterans and has made substantial strides, but improvements are still necessary," said AMA Board of Trustees member and Board Chair-elect Gerald E. Harmon, M.D.
Ensuring the Timely Transfer of Prescriptions to New Pharmacies
Physicians and patients often scramble when health care payers change their in-network retail pharmacies. To ensure a seamless and accurate transfer of prescriptions takes place, the AMA today adopted policy advocating for insurers or other third party payers to provide 60-days advance notice of changes in their retail pharmacy networks to patients and their physicians. The AMA's new policy also encourages that insurers or other third party payers allow patients to choose a new pharmacy of choice within the network.
"Patients depend on getting their prescriptions in a timely and convenient fashion," said AMA Immediate Past Chair Stephen R. Permut, M.D., J.D. "Our new AMA policy calls on payers and in-network pharmacies to transfer the prescription - as initially prescribed with regard to refills, substitutions, etc. - to the patient's pharmacy of choice rather than rely on physicians and patients to initiate such a transfer. We also ask that payers have safety mechanisms in place to ensure the formulation is available to the patient without a lapse in dispensing."
Weekend and Holiday Access to Medications
Many insurance companies do not have staff available on weekends or holidays to approve prescription drug coverage, which leaves some discharged patients without access to new medications. The AMA today urged pharmacy benefit managers (PBMs), health insurers and pharmacists at a national level to address this problem.
"The simple fact is that patients need access to prescriptions - regardless of the day of the week," said Dr. Permut. "Patients who are stabilized on new medications may face undue harm if they are denied access to that medicine once they leave the hospital. The AMA will work with all interested parties to address this issue to ensure that patients have access to vital medications regardless of discharge date."
To protect patient safety and prevent readmissions, the policy calls for PBMs, health insurers and pharmacists to always be available to resolve issues of coverage and/or formulary on holidays and weekends.
