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American Medical Association and State Medical Societies Back Plan Limiting Insurers Administrative Spending

Excerpt: Physician and hospital organizations have expressed general support for a proposal from state insurance commissioners on what health insurers should be allowed to consider medical spending under new health system reform regulations.

American Medical Association Urges Ban on TV Drug Ads

"The American Medical Association voted this week in favor of a ban on ... direct-to-consumer advertising of prescription drugs and medical devices.... [O]nly the Food and Drug Administration or Congress has the power to ban pharmaceutical advertising.... 'Today's vote in support of an advertising ban reflects concerns among physicians about the negative impact of commercially-driven promotions, and the role that marketing costs play in fueling escalating drug prices,' AMA board chair-elect Patrice A. Harris said ... 'Direct-to-consumer advertising also inflates demand for new and more expensive drugs, even when these drugs may not be appropriate.' "

AMA Supports Georgia Insurance Commissioner's Defense of Prompt-Pay Law

"The [amicus curiae brief filed by the] American Medical Association (AMA) and the Medical Association of Georgia (MAG) ... in the U.S. Eleventh Circuit Court of Appeal, argues the trial court erred in concluding that [ERISA] exempts third-party administrators from accountability to Georgia's prompt payment law. The AMA and MAG urged the federal appeals court to lift the injunction and declare that Georgia's prompt payment law is not preempted by ERISA, or remand the case so the ERISA preemption issues can be properly addressed in court."

'Principles of Managed Care' Based on Policy Developed by AMA's Council on Medical Service (PDF)

34 pages. Excerpt: Principles of Managed Care,' a booklet largely based on policy developed by the AMA's Council on Medical Service, provides guidelines for establishing equitable and effective policies and procedures for managed care practices to ensure high-quality health care services for patients and fairness for physicians. The AMA strongly encourages managed care organizations and payer groups to follow the guidelines; public or private entities that evaluate managed care for[.]

New AMA Guidelines on Medical Tourism (PDF)

1 page. Excerpt: The AMA advocates that employers, insurance companies, and other entities that facilitate or incentivize medical care outside the U.S. adhere to the following principles[.]

AMA Wants Physicians to Take Action for Accurate Insurer Payments This Fall

Excerpt: As part of its national campaign to save the health system billions of dollars by improving the accuracy and efficiency of medical claims processing, the American Medical Association (AMA) today announced it has selected November for the first national Heal that Claim Month. Many physician practices often experience an increase in claim denials from health insurers during the last quarter of the year, making November an ideal time to appeal inappropriately underpaid and denied claims.

AHA, AMA Dismiss Surprise Billing Rule Lawsuit, Plan Further Legal Action

"The American Hospital Association (AHA) and American Medical Association (AMA) filed a motion to dismiss their lawsuit challenging the federal government's final rule on surprise billing released last year, but cautioned more litigation is pending. The health care lobbying groups say the August 2022 final rule on arbitration still poses concerns for providers."

AMA Sues MultiPlan, Insurers Alleging 'Cartel' to Fix Physician Prices

"Cost management company MultiPlan is facing yet another lawsuit for allegedly conspiring to underpay providers -- this time, from the largest physician association in the United States. The American Medical Association's complaint, filed Thursday in an Illinois district court, accuses MultiPlan of colluding with major health insurers to set artificially low reimbursement rates for out-of-network care, forcing providers to accept payments that often don't cover their operating costs." [American Medical Association v. MultiPlan, No. 24-10959 (N.D. Ill. complaint filed Oct. 24, 2024)]

AMA Prescribes Actions to Ease Negative Effects of High-Deductible Health Plans

"The new AMA policy encourages employers to: [1] Provide robust education to help patients make good use of their benefits to obtain the care they need. [2] Take steps to collaborate with their employees to understand employees' health insurance preferences and needs. [3] Tailor their benefit designs to the health insurance preferences and needs of their employees and their dependents. [4] Pursue strategies to help enrollees spread the costs associated with high out-of-pocket costs across the plan year."

New AMA Health Insurer Report Card Finds Need for More Accuracy

Excerpt: The American Medical Association (AMA) today announced that one in five medical claims are processed inaccurately by health insurers[.]