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New Jersey Academy of Family Physicians

House of Delegates

The NJAFP House of Delegates meets each year in conjunction with the NJAFP FamMed Forum.

2019 Resolutions

Each year, the NJAFP House of Delegates considers resolutions for presentation to the New Jersey Legislature, American Academy of Family Physicians Congress of Delegates and other policymaking bodies.  

For more information on how to write and propose a resolution, please contact us.

Resolution #1: Insurance coverage for Acupuncture treatment for Chronic Pain

NJAFP 2019 Resolution #1
Proposed by Sally Mravcak, MD
Insurance coverage for Acupuncture treatment for Chronic Pain

Whereas research has found acupuncture to effectively treat many chronic pain conditions, and

Whereas access to alternative pain control strategies has become increasingly important in the midst of the opioid crisis, and

Whereas access to acupuncture treatment is often limited by insurance coverage, now therefore be it

RESOLVED: That the NJAFP petition the AAFP through either a resolution to the 2019 Congress of Delegates, or a formal request to the AAFP Board, or both to create AAFP policy supporting wide-spread insurance coverage of acupuncture for pain control when ordered by a licensed medical provider, and be it further

RESOLVED: that the NJAFP promote legislation in the New Jersey General Assembly mandating insurance coverage for acupuncture for treatment of chronic pain.

Resolution #2: Pharmacy Formularies

NJAFP 2019 Resolution #2
Proposed by Kathy Saradarian, MD
Pharmacy Formularies

 

Whereas:  Physicians carefully choose medications for their patients, and

Whereas:  Patients are often on the same medication for many years which are working well for that patient, and

Whereas:  Insurance companies change their formularies at least yearly and arbitrarily drop generic medications from their formularies in lieu of others, and

Whereas:  Changing a patient’s medication yearly poses a health hazard and adds to cost of medical care, and

Whereas: Software solutions available to health insurance companies such as CoverMyMeds have the ability to efficiently automate the Prior Authorization process, now therefore be it

RESOLVED:  That the NJAFP pursue legislation and/or regulation in New Jersey requiring that all generic medications in a class should be in a plan’s formulary, and be it further

RESOLVED:  That the NJAFP pursue legislation and/or regulation in New Jersey requiring that all pharmacy benefits managers covering patients in the state inform the prescribing provider of all formulary alternatives to a medication when denying same medication immediately upon denial, while also providing a mechanism to rapidly appeal the denial, and be it further

RESOLVED:  That the NJAFP delegation to the AAFP Congress of Delegates submit a resolution at the 2019 Congress with resolved clauses including that the AAFP petition CMS as well as all national health insurance companies and pharmacy benefits managers to include all generic medication in a class within a health plan’s formulary, and that the AAFP petition CMS as well as all national health insurance companies and pharmacy benefits managers implement a system that informs the proscribing provider of all formulary alternatives to a medication when denying same medication immediately upon denial, while also providing a mechanism to rapidly appeal the denial.

Resolution #3: Insurance Plan Participation Linked to Hospital Privileges

NJAFP 2019 Resolution #3
Proposed by Kathy Saradarian, MD
Insurance Plan Participation Linked to Hospital Privileges

Whereas:  Many primary care physicians no longer admit and treat patients in the hospital, and

Whereas:  Many hospitals have modified privileges to create categories for doctors that do not actively admit, and

Whereas:  Many insurance companies rely on hospitals to provide letters recommendations for physicians to be privileged or continue to be privileged with insurance companies, and

Whereas:  Some insurance companies even base individual plan participation on the types of privileges help held at specific hospitals, now therefore be it

RESOLVED:  That the NJAFP develop a policy against Health Insurance Companies privileging doctors based on their hospital privileges and hospital letter of recommendations, and be it further

RESOLVED:  That the NJAFP open communications with the major health insurance companies in New Jersey to discuss alternative methods to credential physicians not based on hospital privileges and recommendations, and be it further

RESOLVED:  That the NJAFP delegation to the 2019 Congress of Delegates present a resolution to the AAFP COD requiring the AAFP to create policy against Health Insurance Companies privileging doctors based on their hospital privileges and hospital letter of recommendations, and further requesting that the AAFP engage the major national health insurance companies to develop methods to credential doctors that don’t depend on hospital privileges and letters of recommendations.

Resolution #4: Scope of Care in the Hospital Setting

NJAFP 2019 Resolution #4
Proposed by Peter Carrazzone, MD
Scope of Care in the Hospital Setting

Whereas:  Family Physicians have broad medical training which includes in-patient hospital medicine, and

Whereas: Studies indicate that primary care physicians who attend their patients in the hospital setting have lower mortality rates and lower thirty-day readmission rate compared to hospitalists implying Family Physicians have superior quality, outcomes and value in this setting, and

Whereas:  There has been a nationwide trend where hospitals have hired hospitalists and intensivists to care for patients in their hospitals, and

Whereas: In some cases, hospitals have restricted admitting privileges to the intensive care unit and at times to the hospital itself for independent Family Physicians, now therefore be it

RESOLVED:  That the NJAFP request, through communication with the AAFP Board of Directors and/or through presentation of a resolution at the 2019 Congress of Delegates, that the AAFP petition the American Hospital Association to create policy stating that member hospitals remove undue barriers and restriction of admitting privileges to hospitals and intensive care units for independent qualified Family Physicians who continue to desire to practice hospital medicine, and be it further

RESOLVED: That the NJAFP request, through communication with the AAFP Board of Directors and/or through presentation of a resolution at the 2019 Congress of Delegates, that the AAFP obtain a legal evaluation of the right of a hospital to revoke admitting privileges either to the intensive care unit or to a hospital itself purely because the applicant for such privileges is not a hospital contracted intensivist or hospital contracted hospitalist.

Resolution #5: Oppose Criminalization of Physicians Providing Abortion Care

NJAFP 2019 Resolution #5
Proposed by Kathy Saradarian, MD
Oppose Criminalization of Physicians Providing Abortion Care

Whereas: the AAFP has resolved that it supports a woman’s access to reproductive health services and opposes non-evidence-based restrictions on medical care and the provision of such services,[i] and

Whereas:  the AAFP has historically supported the rights of family physicians to determine their own scope of practice and that a broad scope of practice is associated with lower physician burnout[ii], and

Whereas:  one in four women in the United States will have an abortion by the age of 45[iii], and

Whereas:  abortions have a have a very low rate of complications requiring hospitalization, approximately 0.5% or less,[iv] making them one of the safest office procedures physicians perform, and

Whereas:  studies done in Texas during the period where the majority of their abortion clinics were closed found an increased rate of maternal mortality[v], and

Whereas:  many states are enacting laws to prohibit abortion under most circumstances (like Indiana, Florida and Iowa’s fetal heartbeat bills) in the hopes that the legal challenges will reach a friendly Supreme Court, and

Whereas:  some of the state laws being proposed will criminalize physicians for performing abortions, and

Whereas:  physicians providing abortion care are doing so at the request of their patients, now therefore be it

RESOLVED: that the NJAFP delegation to the AAFP Congress of Delegates will sponsor or co-sponsor a resolution at the 2019 COD requesting that the AAFP publicly oppose any law which would criminalize physicians for providing abortion care.


[i] American Academy of Family Physicians. Congress of Delegates. Resolution No. 504: Support the Women’s Health Protection Act

[ii] Porter, Annals of Fam Med 16200-205 May/June 2018

[iii] Jones RK, Jerman J. Population Group Abortion Rates and Lifetime Incidence of Abortion: United States, 2008-2014. Am J Public Health. 2017;107(12):1904-1909

[iv] http://www.nationalacademies.org/hmd/Reports/2018/the-safety-and-quality-of-abortion-care-in-the-united-states.aspx. March 2018

[v] Grossman D, The Public health threat of anti-abortion legislation Contraception 89 (2014) 73-74)

Resolution #6: Affirming the Safety and Legality of Abortion

NJAFP 2019 Resolution #6
Proposed by Kathy Saradarian, MD
Affirming the Safety and Legality of Abortion

Whereas: abortion is common, as 1 in 4 women will have an abortion before the age of 45[i], and whereas abortion is safe, with major complication rates at less than 0.5%[ii], and

Whereas: Roe vs. Wade affirmed that the decision to terminate a pregnancy was a privacy issue between a woman and her physician[iii], and

Whereas: the American Academy of Family Physicians (AAFP) has stated that they support a woman's access to reproductive health services and oppose non-evidence-based restrictions on medical care and the provision of such services[iv] without specific reference to abortion services, and

Whereas: medical associations including the American College of Obstetricians and Gynecologists (ACOG) have issued official statements of policies in support of a woman’s right to safe and legal abortion[v], and

Whereas: abortion access in the U.S. has been declining as state legislative efforts to target regulations of abortion providers[vi] have therefore further restricted abortion[vii], and

Whereas: at least sixteen states have laws that would negate the legal status of abortion in the absence of Roe v. Wade[viii], now therefore, be it

RESOLVED: that the NJAFP take a resolution to the AAFP Congress of Delegates asking the AAFP to affirm the legality of Roe v. Wade in the form of a policy statement, and be it further

RESOLVED: that the NJAFP take a resolution to the AAFP asking that the AAFP partner with ACOG in position papers to defend access to safe and legal abortion across the US.

RESOLVED: that the NJAFP take a resolution to the AAFP supporting the right of family physicians to provide medication abortions with mifepristone in their general family practices.


[i] Jones, Rachel K., Jerman, Jenna, “Population Group Abortion Rates and Lifetime Incidence of Abortion: United States, 2008-2014” October 19, 2017 doi:https://doi.org/10.2105/AJPH.2017.304042

[ii] White K, Carroll E and Grossman D, Complications from first-trimester aspiration abortion: a systematic review of the literature, Contraception, 2015, 92(5):422–438, doi:10.1016/j.contraception.2015.07.013.

[iii] Roe v. Wade, 410 U.S. 113 (1973).

[iv] Resolution No. 504 (New York C) - Support the Women’s Health Protection Act, COD June 2014.

[v] ACOG College Statement of Policy as issued by the College Executive Board, January 1993.

https://www.acog.org/-/media/Statements-of-Policy/Public/sop069.pdf?dmc=1&ts=20181127T0502387386

[vi] Gold RB and Nash E, TRAP laws gain political traction while abortion clinics—and the women they serve—pay the price, Guttmacher Policy Review, 2013, 16(2):7–12.

[vii] Texas Policy Evaluation Project (TxPEP), Rapidly changing access to abortion in Texas, 2013. http://www.utexas.edu/cola/orgs/txpep/_files/pdf/Rapidly-Changing-Access-to-Abortion-in-TX-18Jul2014.jpg

[viii] “Abortion Policy in the Absence of Roe.” Guttmacher Institute, 17 Dec. 2018, www.guttmacher.org/state-policy/explore/abortion-policy-absence-roe.

Resolution #7: Rutgers - Newark School of Medicine

NJAFP 2019 Resolution #7
Proposed by Arnold Pallay, MD
Rutgers - Newark School of Medicine

 

Whereas the Rutgers - Newark School of Medicine has established a primary care track to attract new matriculating students to primary care, especially in the greater Newark community and

Whereas the school has established a special three-year program to select students to attempt to meet that goal and

Whereas the program as currently constructed identifies only Internal Medicine, Pediatrics or Med/Peds as qualified for that program and

Whereas Family Medicine is the specialty most committed to providing such community based primary care, including our Medicine and Pediatrics colleagues and

Whereas this precludes and discriminates interested students from choosing Family Medicine in a three year medical school program of study.

RESOLVED that NJAFP shall promote and push the Rutgers Newark School, through its established Department of Family Medicine, to include family medicine as a qualified choice for select students for the program who are committed to a career in primary care to help service the greater Newark community.

http://njms.rutgers.edu/admissions/programs_accelerated_md.cfm

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Resolution #8: Prompt discharge summaries for Medicare patients

NJAFP 2019 Resolution #8
Proposed by Sara Leonard, MD
Prompt discharge summaries for Medicare patients

 Whereas discharge summaries from hospitals and post-acute care facilities are essential to the provision of high quality transitional care management by primary care physicians, and

Whereas current CMS rules requiring discharge summaries be completed within 30 days of discharge do not reflect the importance of vital medical information being available to the primary care physician at the point of care, which generally occurs 48 hours to 7 days following discharge, and which is a goal within several CMS quality initiatives, and

Whereas the Medicare population is particularly vulnerable to post-discharge medication errors and complications which may lead to readmissions, morbidity, and mortality, now therefore be it

RESOLVED that the NJAFP request, through communication with the AAFP Board and resolution to the 2019 AAFP Congress of Delegates that AAFP petition CMS to re-evaluate its current policy on the time requirements for discharge summaries. And be it further

RESOLVED that AAFP petition CMS to require hospitals and post-acute care facilities to provide primary care physicians with discharge summaries within 7 days to enable physicians to provide the highest quality transitional care management.

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