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Life Health > Health Insurance > Health Insurance

AMA to insurers: Be fair to doctors

By Allison Bell

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A legislative body for U.S. doctors handled concerns about narrow health plan networks quickly on Sunday. Members of the American Medical Association House of Delegates addressed the network issue by passing Resolution 119, a measure that reaffirms established AMA policy.

The AMA has already described the standards it thinks health insurers should follow when terminating relationships with the physicians in their provider networks, the group says.

“The AMA believes a physician should be afforded due process if the professional conduct of the physician is reviewed and as a result of the review the reputation, professional status, or livelihood of the physician may be negatively impacted,” the group says in a comment on one California contract termination court case.

The AMA has argued that insurers should respect the importance of the continuity of care and give affected physicians written notices of reasons for termination. They also said that insurers should give affected physicians a chance to appeal the notices and give patients information about other plans from the same carrier, out-of-network benefits, or other means the patients can continue to see their physicians.

AMA House members included reaffirmation of the contract termination standards in a package of uncontroversial legislation. The AMA also named Dr. Steven Stack, a Lexington, Ky., emergency room physician, the AMA president-elect. Stack, 43, has a bachelor’s degree from the College of the Holy Cross and a medical degree from Ohio State University.

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