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Among healthcare industry bodies that lobby, the American Medical Association (AMA) has few equals. Look no further than the new ICD-10 compliance date for evidence bearing out that assertion.
The AMA outspends AHIMA and other major ICD-10 players on lobbying efforts, by a rather wide margin, and calling on House Speaker John Boehner likely helped its cause, but the real ace up its sleeve just might be several key relationships in the right places of Congress.
Now that the association eked out a year’s delay, the second phase of its lobbying strategy – calling on Congress to legislatively rule out the ICD-10 conversion altogether – remains.
Will the AMA hold its fire? Or will the group continue its crusade to stop ICD-10 entirely?
In 2011, the AMA’s lobbying shop spent $20.9 million, hired five outside lobbying firms and was represented by 66 lobbyists. Lobbying was not AMA’s only advocacy tool; the group also has a powerful Political Action Committee that has contributed over $250,000, including contributions to 59 current members of Congress, since 2011. The group’s resources and status as a premier healthcare lobbying association has helped it build the relationships with government that are vital to such lobbying efforts.
The ICD-10 battle centers on swaying the opinion of Congress or the Department of Health and Human Services (HHS), which controls ICD-10 implementation regulations. AMA’s initial public steps in their campaign included sending two letters to government officials.
In the first letter, sent to Speaker Boehner, the AMA asked the Speaker to stop implementation of ICD-10, via legislation, as the Speaker does not have jurisdiction over ICD-10 implementation. In the second letter, sent to Secretary Sebelius, the AMA asked her to halt ICD-10 implementation altogether. The letters cited health IT regulations that are currently being implemented as well as the President’s recent executive order for federal agencies to reassess and streamline regulations, as reasons to halt ICD-10 implementation.
On February 16, 2012, Secretary Sebelius announced that HHS would be delaying implementation of ICD-10, which had been slated to take effect on October 1, 2013. Following that, on April 9, 2012, the Secretary announced that ICD-10 implementation would officially be delayed for one year until October 1, 2014.
The AMA responded favorably, saying its members and “physicians across the nation appreciate that CMS has proposed delaying the ICD-10 implementation date” – but the association gave no indication that its lobbying against ICD-10 was over.
This victory for the AMA demonstrated the strength of its lobbying operation. The decision signaled that while HHS was willing to listen to the concerns of advocacy groups like AMA, they are not yet ready to discuss halting implementation completely.
To get this important first victory and chart its course ahead, the AMA took a two-pronged approach, with Congress and its ability to repeal the law being one focus, and HHS and its ability to delay/tweak implementation being the other.
The letter to Speaker Boehner represented AMA flexing its relationships. The organization currently employs seven in-house lobbyists that have worked in Congress, for eleven different Members, including five that worked specifically on Health Issues. By calling Congress’s attention to this issue at a time when regulation was considered a dirty word, the AMA was betting that Congress would be willing to listen.
With the AMA’s connections to Congress, the group would have no trouble targeting and reaching their audience. Current AMA lobbyists that worked in Congress include:
• Lindsey Brill
o Legislative Assistant (Health Issues) - Lincoln D. Chafee (I)
o Legislative Assistant (Health Issues) - Rep. Walter B. Jones (R-NC)
• Dana Lichtenberg
o Legislative Director (Health Issues) - Rep. Bart Gordon (D-TN)
o Legislative Assistant (Health Issues) - Rep. Eddie Bernice Johnson (D-TX)
o Scheduler; Executive Assistant - Rep. Brad Sherman (D-CA)
o Legislative Correspondent - Rep. Vic Fazio (D-CA)
• Jason Marino
o Legislative Assistant (Health Issues) - Sen. Robert C. Byrd (D-WV)
• Thomas Cordrey Roberge
o Legislative Counsel - Sen. Peter G. Fitzgerald (R-IL)
• Jennifer Lee Shevchek Meeks
o Legislative Aide (Health Issues) - Former Sen. Arlen Specter (R/D-PA)
• Cybil Roehrenbeck
o Legislative Counsel - Rep. Walter B. Jones (R-NC)
• Carol L Vargo
o Legislative Assistant - Rep. Jim McDermott (D-WA)
Next for AMA came the letter to Sebelius, which expressed similar concerns to the Boehner letter. In the letter, the AMA made it clear that Mari Savickis, Assistant Director for Federal Affairs would be in charge of their efforts with HHS and CMS. This was a clear play to maximize AMA’s strongest connection to HHS and CMS. Savickis served at HHS in multiple roles including:
- CMS Detailee - Office of the National Coordinator for Health Information Technology (HHS)
- Project Officer - Division of Medicare Payment Policy Demonstrations (CMS)
- Special Assistant to Director for Center for Medicare Management
- HIPAA Outreach Specialist
- Assistant to Director of Physicians’ Regulatory Issues Team (PRIT)