AMA seeks greater oversight of MA plans
By HME News Staff
Updated 9:04 AM CDT, Tue June 11, 2024
CHICAGO – Physician and medical student leaders at the Annual Meeting of the American Medical Association (AMA) House of Delegates approved policies to address the need for greater oversight of health insurers’ use of prior authorization controls on patient access to care. The new policies address insurer accountability and transparency for PA denials. “Waiting on a health plan to authorize necessary medical treatment is too often a hazard to patient health,” said AMA Board Member Marilyn Heine, M.D. “To protect patient-centered care, the AMA will work to support legal consequences for insurers that harm patients by imposing obstacles and burdens that interfere with medically necessary care.” Surveys of physicians have consistently found that excessive authorization controls required by health insurers persistently lead to serious harm when necessary medical care is delayed, denied, or disrupted. The AMA will also work to ensure that increased legal accountability of insurers is not precluded by clauses in beneficiary contracts that may require pre-dispute arbitration for prior authorization determinations or place limitations on class action.
Comments