Noting that “the health insurance industry has a crisis of credibility,” the American Medical Association has released a set of 10 Health Insurer Code of Conduct Principles that it said will “bring transparency and accountability to the multibillion-dollar health insurance industry.”
AMA offers code of conduct for insurers
The principles include subjecting a decision to cancel a person's coverage to independent, outside review; spending the “substantial bulk” of a premium dollar on direct medical care; and requiring that only a physician can make a decision to deny care on the grounds it is not “medically necessary.”
Other principles call for reducing administrative complexity and confusion, and focusing “physician profiling” initiatives on improving quality not reducing costs.
The code was developed by the AMA and has been endorsed by 68 state and specialty medical societies. The AMA said it has sent letters to the nation's eight largest insurers seeking their compliance.
Representatives from the industry trade group America's Health Insurance Plans, UnitedHealthcare and the Blue Cross and Blue Shield Association could not be reached for comment by deadline.
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