Report: 2013 Annual Meeting of the AMA House of Delegates

Monday, July 01, 2013 12:34 PM
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Colorado leaders elected to national office, set ICD-10 policy

Delegates and leaders representing the Colorado Medical Society traveled to Chicago June 15-19 to attend the annual meeting of the American Medical Association House of Delegates. Coloradans experienced great success in elections and policymaking, particularly among residents, students and young physicians.

ICD-10 safety net for physicians

The four Colorado delegates to the AMA – M. Ray Painter Jr., MD, and A. Lee Morgan, MD, delegation co-chairs; Lynn Parry, MD; and Brigitta Robinson, MD; along with the four alternate delegates – David Downs, MD; Jan Kief, MD; Mark Laitos, MD; and Tamaan Osbourne-Roberts, MD – worked hard to carry an important resolution to passage through the House of Delegates. It involved the transition to ICD-10 code sets to report medical diagnoses, which is set to take effect Oct. 1, 2014. The AMA’s current policy is to delay or stop the new diagnosis system.

Colorado successfully added a clause to Resolution 236, “Action to Eliminate Implementation of ICD-10,” that would enact an “implementation period” should the AMA fail to stop or delay ICD-10. The clause would direct the AMA board to seek federal legislation to enact a two-year period during which payers would not be able to deny payment based on the specificity of ICD-10 or ICD-11 diagnosis.

Payers would be required to provide feedback for an incorrect diagnosis. Additionally, no payer would be able to reclaim payments for diagnosis codes that lack ICD-10/11 specificity, including through Recovery Auditors Contractors, or RACs.

As the head of a company that helps physicians correctly code and bill, Painter understands the critical nature of this issue. He said that physicians would still need to prepare for ICD-10 but wouldn’t be penalized in payment for not being completely accurate in their diagnosis and would receive crucial information on correct ICD-10 codes. The new code set adds thousands of additional codes and most do not have a direct correlate to an ICD-9 code.

“We had to work to make sure everyone understood the resolution, but in actuality it was passed unanimously. For a House divided by many philosophies, we all came together on this issue. Some of the AMA leadership said this may have been the most important policy passed at the meeting,” Painter said.

New leaders

Carolynn Francavilla, MD, who is finishing her second year of residency with the University of Colorado Family Medicine Residency at Rose, was elected to the alternate delegate position of the AMA Resident and Fellow Section (AMA-RFS) Governing Council. RFS comprises more than 38,000 resident and fellow members of the AMA and the seven-member governing council is the leadership of RFS.

In her role as alternate delegate, Francavilla will work with the RFS delegate to advocate for RFS resolutions in the AMA House of Delegates and organize the delegation’s positions on all of the items of business at the House of Delegates. Francavilla says she recognizes the unique perspective residents and fellows bring to the AMA on patient care and the health care system and looks forward to working to make residency a better experience for her colleagues.

Steve Sherick, MD, is the current chair of the AMA Young Physicians Section (YPS). In this position, he serves as the spokesman for young physicians nationwide and is charged with directing the policy creation, national meetings, intra-AMA politics and outreach operations for YPS. Through his term ending in June 2014, he hopes to create at least 10 resolutions with the support of his section that will “help push the envelope of AMA policy,” he said.

Paul Pukurdpol, a third-year medical student from the University of Colorado School of Medicine, was elected to the position of vice speaker of the AMA Medical Student Section (AMA-MSS) Governing Council. The eight-member council is responsible for appointing the remainder of the MSS leadership, carrying out policies and actions items adopted by the MSS Assembly, and directing the MSS agenda and strategy.

In his role as vice speaker, Purkurdpol will work in collaboration with the speaker to develop programming and preside over two national meetings of the assembly, oversee and enforce campaign rules, and organize and lead orientation for new delegates and alternate delegates at the assembly.

A Colorado native, Purkurdpol attended the University of Colorado for his BA, MPH and now MD, and is passionate about developing the next generation of health care leaders to confront the challenges of a rapidly changing health system. “The MSS is the largest gathering of future health care leaders in the nation and I am proud to lead our annual meetings,” he said.

Bianca Pullen, a medical student finishing her first year at the University of Colorado School of Medicine, was elected to the position of region chair for Region 1 of the AMA MSS. She will be responsible for fostering communication among individual school sections and state sections, as well as helping a host school produce a successful region meeting.

“Working in this role presents me with the challenge of engaging schools that are typically absent from MSS activities,” Pullen said. “My passion for serving people extends beyond my patients. I would like to know how we can better serve all sections in Region 1. The AMA MSS provides many students with leadership training and community service involvement.” Dean Drizin was selected to represent medical students nationwide on the Council on Medical Service. This council studies and evaluates the social and economic aspects of medical care and suggests means for the timely development of services in a changing socioeconomic environment.

Drizin recently finished his third year at the University of Colorado School of Medicine where he served as the CUSOM chapter president of the Colorado Medical Society and the AMA, and represented medical students from the western states in the AMA House of Delegates. He is pursuing an MD/MBA dual degree from CUSOM and the Wharton School at the University of Pennsylvania.

“My involvement in the Colorado Medical Society and the American Medical Association has been a highlight of my medical education,” Drizin said. “I particularly value the relationships I have developed with physicians from across Colorado, whom I look up to as role models, mentors and friends.”

Lazarus completes year as president

The 2013 meeting marked the completion of service for AMA President Jeremy Lazarus, MD, of Denver. He now becomes immediate past president and will continue to serve on the AMA Board of Trustees.

In his final presidential address before the House of Delegates, he reflected on events including the Supreme Court’s ruling on the Affordable Care Act, the gun tragedies in Colorado and Connecticut, and the bombings at the Boston Marathon. He emphasized that physicians rallied following these events to ensure as many patients as possible had access to care, and to address gun violence and mental illness. Physicians continually prove their strength and commitment in how they care for patients, he said.

He referred to the AMA’s legislative victories and progress in long-term goals such as addressing health insurer practices and repealing Medicare’s sustainable growth rate formula and predicted a bright future for the AMA. “On the table is a better health care system, better outcomes for our patients, better training and education for tomorrow’s physicians, and a brighter practice picture for physicians today,” Lazarus said.

Colorado ICD-10 Coalition pledges to help physicians prepare for coding switch

The Colorado ICD-10 Coalition, a statewide organization of interested educators, consultants, physician and practice representatives, has pledged to help Colorado physicians prepare their o¬ffices for the scheduled implementation of the ICD-10 diagnosis codes by the Oct. 1, 2014 deadline.

Though the AMA is actively lobbying to stop or delay the implementation of ICD-10, physicians and their staffs would be wise to continue their preparations so they don’t feel overwhelmed should the deadline stand, said Marilyn Rissmiller, CMS senior director of the Division of Health Care Financing.

The coalition’s resources include a series of webinars, educational events, worksheets, task lists and apps that are available on the group’s website, The two most recent webinars, Project Planning Phase 1 and 2, provide viewers with information on how to jumpstart this transition.

To learn more and to access resources to help you navigate the ICD-10 maze, go to


Posted in: Colorado Medicine | Practice Management | Coding and Billing | Initiatives | AMA


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