Ama Policy

Promoting Accountability in Prior Authorization D-320.983

ERISA-Med. Nec. Decisions-Deadlines, State Medical Necessity Decisions-Deadlines

Our AMA will study the frequency by which health plans and utilization review entities are using peer-to-peer review prior authorization processes, and the extent to which these processes reflect AMA policies, including H-285.987 (“Guidelines for Qualifications of Managed Care Medical Directors”), H-285-939 (“Managed Care Medical Director Liability”), H-320.968 (“Approaches to Increase Payer Accountability”), and the AMA Code of Medical Ethics Policy 10.1.1 (“Ethical Obligations of Medical Directors”), with a report back to the House of Delegates at the 2020 Annual Meeting.

Policy Timeline

Res. 709, A-19