Ama Policy

Payment for Physicians’ Services H-385.990

Fee Schedules

Our AMA:

(1) Recognizes the validity of a pluralistic approach to third party reimbursement methodology and recognizes that indemnity reimbursement, as a schedule of benefits, as well as “usual and customary or reasonable” (UCR), have positive aspects which merit further study.

(2) Reaffirms its support for: (a) freedom for physicians to choose the method of payment for their services and to establish fair and equitable fees; (b) freedom of patients to select their course of care; and (c) neutral public policy and fair market competition among alternative health care delivery and financing systems.

(3) Reaffirms its policy encouraging physicians to volunteer fee information to patients and to discuss fees in advance of services, where feasible.

(4) Urges physicians to continue and to expand the practice of accepting third party reimbursement as payment in full in cases of financial hardship, and to voluntarily communicate to their patients through appropriate means their willingness to consider such arrangements in cases of financial need or other circumstances.

Policy Timeline

CMS Rep. B, I-83 Reaffirmed: BOT Rep. TT, I-92 Reaffirmed: CMS Rep. E, A-93 Reaffirmed: CLRPD Rep. 1, I-93 Reaffirmed: Sub. Res. 137, A-94 Reaffirmed: CMS Rep. 5, A-04 Reaffirmed: BOT Rep. 10, I-05 Reaffirmed in lieu of Res. 127, A-10 Reaffirmed: CMS Rep. 01, A-20