1. Our AMA actively supports payment to physicians by contractors and third party payers for physician time and efforts in providing case management and supervisory services, including but not limited to coordination of care and office staff time spent to comply with third party payer protocols.

2. It is AMA policy that insurers pay physicians fair compensation for work associated with prior authorizations, including pre-certifications and prior notifications, that reflects the actual time expended by physicians to comply with insurer requirements and that compensates physicians fully for the legal risks inherent in such work.

3. Our AMA urges insurers to adhere to the AMA’s Health Insurer Code of Conduct Principles including specifically that requirements imposed on physicians to obtain prior authorizations, including pre-certifications and prior notifications, must be minimized and streamlined and health insurers must maintain sufficient staff to respond promptly.

Policy Timeline

Sub. Res. 814, A-96 Reaffirmation A-02 Reaffirmation I-08 Reaffirmation I-09 Appended: Sub. Res. 126, A-10 Reaffirmed in lieu of Res. 719, A-11 Reaffirmed in lieu of Res. 721, A-11 Reaffirmation A-11 Reaffirmed in lieu of Res. 822, I-11 Reaffirmed in lieu of Res. 711, A-14, Reaffirmed: Res. 811, I-19 Reaffirmation: A-22