The American Medical Association during its just-concluded policy-making meeting in Honolulu added new items to its policy agenda, including ones focused on the clinical use of genome sequencing and bringing an end to “pay-for-delay” settlements that critics say keep patients from realizing the benefits of less expensive generic drugs as quickly as they otherwise would.

The association, the nation’s largest physicians’ organization, said new technologies that are providing rapid, low-cost genome sequencing are also creating implementation challenges that need to be addressed if their potential is to be realized. The AMA says it supports regulatory policy that protects patient rights and confidentiality, and enables physicians to access and use such diagnostic tools as clinically appropriate. In addition, the policy calls on the AMA to educate physicians on the clinical uses of such technologies.

“Advances in DNA sequencing technology offer patients and physicians a new diagnostic tool to help improve health outcomes, but clinical challenges must be addressed to realize the full potential benefits of this technology,” says Robert Wah, a member of the AMA’s board. “While cost and time barriers to genetic sequencing have been reduced, important privacy, practice, payment and regulatory issues, including how to compensate physicians and other healthcare professionals for the considerable work-related demands required, must still be addressed.”

The policies adopted cut across science, public health, and legislative issues. They cut across a broad range of issue from hepatitis C prevention to expansion of Medicaid. In all, they reflect a snapshot of a time of great change within healthcare as technology and cost pressures are driving change and physicians seek to protect their income and role as decision makers.

The association also adopted a policy supporting the end of pharmaceutical companies paying generic drugmakers to delay entry into the market of generic versions of brand name drugs that are losing patent protection. The AMA says that practice limits the number of prescription options available to patients and contributes to the growth in healthcare costs.

“Pay-for-delay keeps quality, low cost generic drugs out of the marketplace and unnecessarily drives up costs for patients,” says Patrice Harris, an AMA board member. “In order to ensure the most cost-effective treatment options, this practice must stop.”

Among other measures adopted by the group was a policy to seek federal legislation or regulatory changes to stop Medicare and Medicaid from decertifying physicians due to unpaid student loan debt. Currently physicians with outstanding loan debt are not permitted to accept Medicare and Medicaid patients, which the group says undermines their ability to repay the student loans.

In addition, the AMA voted to recommend a set of principles that it says should be included in a Medicare defined contribution system that would enable beneficiaries to purchase the coverage of their choice from among competing health insurance plans, including traditional Medicare. The groups says the defined contribution framework described by the policy would be similar to the health insurance program for federal employees, including members of Congress. Traditional Medicare, with improvements like caps on out of pocket spending, would remain an option for all Medicare beneficiaries.

The group is calling for an expansion of Medicaid at the state level and for an increase in Medicaid payments to physicians. It is also calling for improvements and innovations in Medicaid, which it says will reduce administrative burdens and deliver healthcare services more efficiently, even as coverage is expanded.