In addition to the work of the AMA on the recovery plan, we are also working at the federal and state level to remove obstacles to supply.
- Leading efforts with national medical specialists and state medical associations to build consensus and influence the provisions of the No Surprises Act.
- Initiating a lawsuit in federal district court (along with the American Hospital Association) alleging that the government’s interim final ruling violates the law and exceeds statutory authority by creating a rebuttable presumption that the arbitrator in the independent dispute resolution process will consider it ” Qualifying Payment Amount” (essentially the median in-network rate) as an appropriate off-network payment amount. A federal judge in TX ruled in favor of a similar case brought by the Texas Medical Association, effectively removing the rebuttable presumption.
- Filed (along with the American Hospital Association) in federal district court (along with the American Hospital Association) an amicus brief in support of a lawsuit brought by the Texas Medical Association arguing that the government’s final rule continues to violate the law and transcends legal authority by adding various extra-legal language specifying the “qualifying payment amount” (essentially the median rate on the network) in favor of health plans and conflicts with Congress’ intended design of the independent dispute resolution mechanism.
- Release of a first toolkit (PDF) to implement the No Surprises Act and a second toolkit (PDF) to implement the billing process for certain off-network services under the No Surprises Act.
- Conducted two national webinars on the No Surprises Act, the first on its implementation and the second on the payment process for physicians and other providers in surprise medical billing situations.
- Remains committed to a fair IDR process, arguing in a recent letter (PDF) to the administration that a balanced IDR process is not anti-patient and pushing back efforts by payers and employers to undermine the process.
- Working directly with CMS to address operational challenges with additional resources for physicians and providers.
- In response to significant concerns from the AMA, the U.S. Department of Health and Human Services (HHS) withdrew the Final Rule to Timely Secure Updated and Necessary Regulatory Assessments (SUNSET), which would have diverted limited HHS resources to mandatory reviews of economically significant regulations and set each regulation 10 years after their enactment or last review.
- CMS will discontinue use of Medical Necessity Certificates and Durable Medical Device Information Forms for multiple items, including oxygen, with service dates on or after January 1, 2023 (PDF). This change will reduce regulatory burden, streamline the coverage process and improve access to quality, affordable care.
- Developing a Guide for Healthcare App Developers to Implement the AMA Privacy Principles (PDF).
- Sending a joint letter (PDF) to the heads of the Office of the National Coordinator for Health Information Technology and the Centers for Medicare & Medicaid Services, urging federal agencies to review their policies regarding application programming interfaces.
- Letter to the Vermont Legislature supporting a Senate bill that would prohibit life, disability and long-term care insurers from discriminating against individuals based on genetic information.
- NOW the 2022 update on the reform of medical liability released! (PDF).
- Assisted the Utah Medical Association in passing the CANDO legislation.
- Provided extensive state MLR resources to the California Medical Association (CMA) in support of efforts leading to passage of the MICRA Modernization Act.
- Bill completed at the request of state medical boards to assist those medical boards in enacting liability protections for public health emergencies and disasters.
- Draft model law to protect doctors from criminal liability in connection with allegations of medical liability.
- Release of the 20th edition of Competition in Health Insurance: A Comprehensive Study of US Markets (PDF), showing that more than 70% of health insurance markets remain highly concentrated.
- Encouraged (PDF) the Department of Justice and the Federal Trade Commission to develop policies protecting against mergers that create or increase health insurers’ buying power in physician markets.
Published Perspectives of AMA Policy Research:
Learn about our efforts covered in the AMA Recovery Plan for America’s Physicians, Public Health and Pandemic Response, and Population Servicing and Health Inequalities.