July 1995 AAOS Report

Academy presents patient protection resolution to AMA

The Academy's delegate to the American Medical Association, James F. Richards Jr., MD, presented a resolution at the June meeting of the AMA's House of Delegates calling for all managed care plans to automatically include a point-of-service feature. This point-of-service feature would allow patients to obtain "out-of-network" services for an additional copayment if they have problems with the services or providers in the plan. William W. Tipton Jr., MD, Academy executive vice president and Michael H. Graham, MD, chairman, Council on Health Policy and Practice also conveyed this position to the AMA Board of Trustees in a special meeting just before the House of Delegates convened. The Academy believes that the point-of-service feature is an important patient protection measure because it ensures that patients will have a way out if they experience inadequate care in a closed panel managed care plan. A recent study commissioned by the Patient Access to Specialty Care Coalition, which is made up of over 90 physician and consumer groups including the Academy, indicates that the point-of-service feature would not significantly affect managed care plan costs. The Academy's resolution called for the AMA to include this point-of-service feature in its proposed Patient Protection Act. The AMA is seeking to have this act included in any federal or state health care reform legislation that is passed. After widespread debate on the issue, the Academy's resolution was referred for additional study. The resolution will be considered again at the House of Delegates Interim Meeting, Dec. 3-6, in Washington, D.C. Before this meeting, Academy representatives will continue discussions with AMA leaders aimed at ensuring that this important patient protection measure is championed by the medical profession.

Also at the meeting, Academy fellow Allen S. Edmonson, MD, made a gallant, but unfortunately unsuccessful attempt to become vice-speaker of the AMA's House of Delegates. "Dr. Edmonson has represented orthopaedics effectively as an AMA delegate from Tennessee, and we congratulate him on his commitment to the organization," said Dr. Tipton.

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