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New AMA insurer’s code of conduct highlights need to earn patient trust
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A new code of conduct released by the American Medical Association calls on insurance companies in the United States to work toward bringing transparency and accountability to their industry.
American Medical Association (AMA) officials introduced its The Health Insurer Code of Conduct Principles, which was developed by the association and endorsed by 68 state and specialty medical societies. It is designed to get health insurers to pledge their commitment to full transparency and accountability with respect to all of their clinical and administrative processes and contains 10 principles the association deemed “critical to an efficient, patient-centered health care system.” These principles focus on health insurer practices that influence the care of patients – including cancellation of coverage, spending on medical services, access to care, fair contracting and patient confidentiality, medical necessity, benefit management, administrative simplification, physician profiling, corporate integrity and claims processing.
Too often an “obstacle”
“Health insurers should provide access to necessary health care, protect the patient-physician relationship and accurately process medical claims, but too often they are an obstacle,” J. James Rohack, MD, AMA president, stated in a release. “The new Health Insurer Code of Conduct Principles will help protect patients and physicians from questionable insurance practices by holding the health insurance industry accountable.”
The move to adopt the new code of conduct includes letters that were sent to the nation’s eight largest health insurers. They seek the insurers’ pledge to comply with the principles. The AMA will also distribute CD-ROMs with resources to help physicians monitor insurer compliance with the code.
Practice Management Center
The AMA has also set up the Practice Management Center, which offers resources AMA officials say will assist physicians in matters of dealing with health insurers who do not abide by the new code of conduct.
The association noted among the societies that that have co-signed the bill are: the American Academy of Orthopaedic Surgeons; American College of Cardiology; American College of Emergency Physicians; American College of Rheumatology; American Gastroenterological Association; and the Congress of Neurological Surgeons.
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