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AMA Policies

Find all American Medical Association House of Delegates policies and Council on Ethical and Judicial Affairs ethical opinions applicable to managed care contracting and the relationship between contracted physicians and health insurers and other payers.

To search for an exact phrase, you should enclose the entire phrase in quotation marks. For example, "patient care".
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Ama Policy

Private Health Insurance Formulary Transparency H-125.979

12/30/2021
ERISA-Med. Nec. Decisions-Deadlines, Med. Adv.-Med. Nec. Decisions-Deadlines, State Medical Necessity Decisions-Deadlines
Federal Law

Title 42-Chapter 7-Subchapter XVIII-Part C. Medicare+Choice Program

08/30/2023 42 USC Section 1395w-22

Benefits and beneficiary protections

Anti-gag clause-Med. Adv., Directories-Med. Adv., Liability-insurer shifting to physician-Med. Adv., Med. Adv.-Med. Nec. Appeals-Deadlines, Med. Adv.-Med. Nec. Decisions-Deadlines, Network Adequacy-Med. Adv., Prohibited financial incentives-Med. Adv., Risk-Physicians Taking-Med. Adv.
Federal Law

Title 42-Chapter IV-Subchapter B-Part 422-Subpart M. Grievances, Organization Determinations and Appeals

08/30/2023 42 CFR 422.568

Standard timeframes and notice requirements for organization determinations

Med. Adv.-Med. Nec. Decisions-Deadlines
Federal Law

Title 42-Chapter IV-Subchapter B-Part 422-Subpart M. Grievances, Organization Determinations and Appeals

08/30/2023 42 CFR 422.570

Expediting certain organization determinations

Anti-retaliation-Med. Adv., Med. Adv.-Med. Nec. Decisions-Deadlines
Federal Law

Title 42-Chapter IV-Subchapter B-Part 422-Subpart M. Grievances, Organization Determinations and Appeals

08/30/2023 42 CFR 422.572

Timeframes and notice requirements for expedited organization determinations

Med. Adv.-Med. Nec. Decisions-Deadlines