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.

Ama Policy

Managed Care Medical Director Liability H-285.939

12/30/2021
Liability-insurer shifting to physician
State Law

North Dakota Century Code-Title 9-Chapter 9-08. Unlawful and Voidable Contracts

08/13/2023 North Dakota Section 9-08-02

Contracts against the policy of the law

Liability-insurer shifting to physician
Ama Policy

Tort Reform and Managed Care H-435.962

10/16/2019
Liability-insurer shifting to physician
State Law

Maryland Statutes-Article 19. Health-General

08/07/2023 Maryland Section 19-710

Health Maintenance Organization licensure-liability shifting and profiling

Liability-insurer shifting to physician, Profiling
State Law

Tennessee Code-Title 56-Chapter 2-Part 1. General Requirements for Doing Business

08/24/2023 Tennessee Section 56-2-124

Hold harmless requirements prohibited

Liability-insurer shifting to physician
State Law

Nevada Admin. Code-Chapter 695C. HMOs; Provider-Sponsored Organizations-Providers of Medical Care

08/15/2023 Nevada Section 695C.190

Requirements for agreement between provider and organization

Liability-insurer shifting to physician
Ama Policy

Preferred Provider Organizations H-415.998

03/14/2019
Liability-insurer shifting to physician, Preemption-ERISA
State Law

Title 41. Insurance-Chapter 39. Managed Care Reform

08/02/2023 Idaho Section 41-3927

Health care providers–Participation by any qualified, willing provider–Contracts–Grievance procedure

Anti-gag clause, Liability-insurer shifting to physician, Most Favored Nation, Termination
State Law

Texas Admin. Code-Title 28-Part 1-Chapter 3-Subchapter X-Division 1. General Requirements

08/24/2023 Texas Section 3.3703

Contracting Requirements

Amendments, Anti-retaliation, Continuity of Care Post-Contract, Fee Schedules, Liability-insurer shifting to physician, Payment Edits, Payment Rules, Profiling, Prohibited financial incentives, Prompt Payment Deadlines, Termination, Termination-Due Process
State Law

Texas Admin. Code-Title 28-Part 1-Chapter 11-Subchapter J. Physician and Provider Contracts and Arrangements

08/24/2023 Texas Section 11.901

Required and Prohibited Provisions

Amendments, Anti-retaliation, Continuity of Care Post-Contract, Fee Schedules, Liability-insurer shifting to physician, Overpayments / Recoupments, Payment Edits, Prompt Payment Deadlines, Termination, Termination-Due Process