Ama Policy

Preferred Provider Organizations H-415.998

Liability-insurer shifting to physician, Preemption-ERISA

The AMA: (1) opposes federal legislation that would preempt state regulation of PPOs; and (2) encourages state medical associations to support legislation that:

(a) insures proper state regulation of PPOs, with particular attention to such practices as arbitrary determinations of medical necessity by carriers, “hold harmless” clauses, and predatory pricing concepts; and

(b) requires independent, physician-directed peer review of the services provided by PPOs.


Policy Timeline

Sub. Res. 16, A-84 Reaffirmed by CLRPD Rep. 3 – I-94 Reaffirmed: BOT Rep. 29, A-04 Reaffirmed: BOT Rep. 19, A-14