AAFP Delegates Tackle Health Care Equity, CME Issues

October 24, 2014 03:47 pm Chris Crawford Washington –

Delegates to the 2014 Congress of Delegates here voted Oct. 21 to support coverage for vasectomies under the Patient Protection and Affordable Care Act (ACA), live CME credit for self-assessment module (SAM) group study workshops and nursing pumping rooms at commercial transportation hubs.

California alternate delegate Jay Lee, M.D., M.P.H., of Long Beach, testifies in support of three resolutions that called for coverage of vasectomies under the Patient Protection and Affordable Care Act. The issue involves a medical decision, he said, not an economic one.

Vasectomy, Female Sterilization Coverage

During the Reference Committee on Education hearing on Oct. 20, delegates discussed a handful of resolutions that addressed government program coverage of female sterilization and vasectomies.

One resolution encouraged the Academy to advocate to CMS that the mandatory 30-day waiting period for sterilization under Medicaid be eliminated.

Minnesota delegate Lynne Lillie, M.D., of Woodbury, testified in support of the resolution. "This was brought to our house of delegates as an issue of disparity in health care," she said. "A person who has private insurance does not have to reschedule if their sterilization procedure has not met the 30-day requirement.

"We don't think there should be discrimination between those on private pay and those on Medicaid."

Michigan delegate Robert Reneker Jr., M.D., also spoke in favor of the resolution, saying, "There is no good, common-sense reason for this waiting period -- period."

Story highlights
  • During the Reference Committee on Education hearing on Oct. 20, delegates discussed a handful of resolutions addressing government health program coverage for female sterilization and vasectomies.
  • Another resolution addressed live CME credit for participating in self-assessment module group study workshops.
  • A third resolution suggested the Academy lobby for nursing pumping rooms at commercial transportation hubs.

During the business session, delegates voted to adopt a slightly amended version of the resolution, which called for the AAFP to advocate for the elimination of "mandatory waiting periods for sterilization procedures for Medicaid patients."

Three additional resolutions addressed coverage for vasectomies under the ACA.

Member constituency delegate Scott Nass, M.D., M.P.A., of Ventura, Calif., spoke in support of what he thought would be the combined resolutions, saying that including vasectomies in the contraceptive options covered under the ACA would provide the reproductive planning care both men and women need.

California alternate delegate Jay Lee, M.D., M.P.H., of Long Beach, also testified in support of the resolutions.

"We don't want this to be an economic decision; we want this to be a medical decision," he said. "If we can use our power to help craft the policy on this decision, then we can help more patients have access to contraception."

Delegates eventually adopted a substitute resolution that combined the three original measures and said the AAFP should advocate that HHS amend the list of preventive services provided under the ACA to include all contraceptive services for patients, regardless of gender.

Live CME Credit for SAM Group Workshops

Texas delegate Erica Swegler, M.D., of Austin, testified as the principal author of a resolution intended to enable members who participate in a self-assessment module (SAM) group study workshop to receive live CME credit for doing so. Family physicians involved in the American Board of Family Medicine (ABFM)'s Maintenance of Certification for Family Physicians (MC-FP) program are required to complete at least one SAM per three-year certification stage, and the workshops are designed to help them do so in collaboration with a group of peers.

During discussion of a resolution to mandate federal insurance medication formularies, Texas delegate Janet Hurley, M.D., of Whitehouse, suggested that because there are state legislative differences, the AAFP could create model state legislation to address the issue.

"Many of us have gone to group SAM settings that are extremely popular both at the AAFP level and many state chapter levels," she said. "It is a live forum with interaction with a moderator. But currently, physicians cannot get live credit for these events."

The resolution asks the AAFP to work with the ABFM to develop a process whereby members who participated in SAM group study workshops could obtain up to eight of the 12 live CME credits required.

Delegates adopted a substitute resolution that simply removed the specific number of live CME credits to be offered.

Nursing Pumping Rooms

California delegate Jeffrey Luther, M.D., Long Beach, was first to the microphone in support of a resolution that asked the Academy to lobby for nursing pumping rooms at commercial transportation hubs. Such rooms, as defined by the U.S. Department of Transportation, are to consist of a non-restroom space that has at a minimum a chair, counter, sink and power for equipment use.

"I would hope there is no one here who is not in favor of breastfeeding," said Luther. "Although breastfeeding has made some inroads in recent years, pumping seems to still be a taboo subject. We view this as an issue of dignity as much as it is of public health.

"It also was pointed out to me that if men were able to breastfeed, this would have been policy years ago."

A substitute resolution that called for the Academy to "advocate," rather than "lobby," for these rooms was ultimately adopted.

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Additional Resources
Storify: Congress of Delegates: Day One(storify.com)

Storify: Congress of Delegates: Day Two(storify.com)