At AMA House of Delegates Annual Meeting, ASCO Supports Action on Utilization Management, Alcohol Use, and Opioid Guidelines

June 7, 2019

From June 8-12, ASCO’s delegates will participate in the American Medical Association’s (AMA) Annual Meeting of the House of Delegates (HOD). The AMA HOD is the principal policy-making body of AMA and meets twice a year to discuss pressing issues and establish association policies. ASCO currently sends three delegates to the AMA HOD: Edward P. Balaban, DO, FACP, FASCO; Thomas A. Marsland, MD, FASCO; and Ray D. Page, DO, PhD, FACOI, FASCO. The society also has two alternate delegates to the HOD: Kristina L. Novick, MD and Steve Y. Lee, MD. ASCO’s Resident Fellow Section Delegate is Erin L. Schwab, MPH, BS, MD.

ASCO’s delegates will introduce three resolutions for consideration by the HOD:

  • Alcohol Consumption and Health: Alcohol is recognized as a modifiable risk fact for several types of cancer, and even light alcohol consumption is associated with a higher risk of certain cancers. ASCO calls on AMA to update existing by policy by recognizing both alcohol consumption and alcohol abuse as modifiable risk factors for cancer.
  • Clarification of Opioid Prescribing Guidelines: The Centers for Disease Control and Prevention (CDC) recently issued a letter to stakeholders, including ASCO, clarifying that clinical practice guidelines specific to cancer treatment, palliative care and end of life care should be used regarding the prescribing of opioids. ASCO urges AMA to continue advocacy to private payers, companies, and states to encourage use of clinical practice guidelines specific to cancer treatment, palliative care, and end-of-life care as per the CDC’s clarifying recommendation.
  • Re-establishment of National Guideline Clearinghouse (NGC): Since funding for the NGC ended abruptly in 2018, there has been no updated resource for physicians who formerly relied on the NGC website for information regarding relevant clinical guidelines. ASCO encourages AMA to research possible and existing alternatives for the functions of the NGC website.

In addition, ASCO has joined others in the provider community by co-sponsoring the two resolutions listed below:

  • Selective Application of Prior Authorization: This resolution calls on AMA to support policies that remove prior authorization requirements from items or services ordered by providers whose prescribing or ordering practices align with nationally recognized evidence-based guidelines, meet with quality criteria, or adhere to high-quality clinical pathways. The same applies for providers whose orders are routinely approved or for providers who are participating in an alternative payment model. ASCO believes that a better approach to utilization management is the adoption of high-quality clinical pathways or coverage policies based on robust analyses of best clinical practices and existing scientific data.
  • Medicare Advantage Step Therapy: This resolution states that AMA should call on the Centers for Medicare & Medicaid Services (CMS)  to immediately publish guidance to health plans that would, at a minimum, lay out patient safeguards enumerated in the recently approved Medicare Advantage and Part D Drug Pricing Final Rule and continue to advocate against the use of step therapy for protected class prescription drugs under Medicare Advantage and Medicare Part B.

Additionally, ASCO will lead the HOD's Cancer Caucus, which provides a forum to address oncology-specific issues that are either being discussed or should be discussed by the HOD.

Stay tuned to ASCO in Action for a recap of the meeting, updates on important policy decisions, and any potential impact on cancer care.