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American Medical Association Approves Resolution From New York State Delegation Which Calls for the Creation of a Code of Conduct for Health Care Insurers

Posted on: Tuesday, 11 November 2008, 00:00 CST

Armed with data that show that ninety percent (90%) of physicians surveyed have had to change the way they treat patients based on restrictions from an insurance company, a delegation of physicians from New York State submitted a resolution calling upon the American Medical Association to create and implement a Code of Conduct for the health insurance industry. By unanimous vote, the AMA's House of Delegates, its supreme operating body, today adopted the Medical Society of the State of New York's resolution which calls upon the AMA to develop a Health Insurer Code of Conduct setting forth clear and concise principles addressing both medical care policies and payment issues to benefit patients, physicians, hospitals and other health care providers. Importantly, survey data collected by the Medical Society of New York State show that health insurer practices and policies often force New York physicians to alter the way they treat patients - and not necessarily for the benefit of patients. Instead the rules appear to have been developed to increase insurer profits at the expense of the best health practices and patients' health. In fact, ninety-two percent (92%) of physicians polled said that insurance company incentives and disincentives regarding treatment protocols "may not be in the best interest of the patients".

Of particular significance to the physician community, the adopted resolution calls upon the AMA to also develop a mechanism to monitor health plan compliance with the "Code of Conduct" and to disseminate widely health plan compliance rates to physicians and patients across the country. "While development of a health plan code of conduct is a valuable first step, the critical element of this resolution is the mechanism that will be employed to monitor health plan compliance with the Code of Conduct," said Michael Rosenberg, MD, President of the Medical Society of the State of New York. "Properly constructed, this tracking mechanism will provide employers and the public with substantive data to empower and inform their decision-making regarding their choice of health insurer. Moreover, the information that is collected can be used by State Attorneys Generals to enforce compliance or to seek significant changes to health plan policies and procedures to protect and assure patient access to medications and treatments prescribed by their practicing physicians," added Dr. Rosenberg.

"Overwhelmingly, physicians agree that decisions on what medications or treatments are right for the patient should be made by the patient's own doctor and not by the health plan or insurance carrier," said David Hannan, MD, MSSNY's President -Elect.

"This is an issue of concern to physicians in every state of our country," said AMA President Nancy Nielsen, MD. "We applaud the work of the Medical Society of the State of New York and look forward to working with physician leaders from across the nation in the development and implementation of the Code of Conduct for all health insurers," stated Dr. Nielsen.

The AMA will work with MSSNY and other state and specialty medical societies as well as other interested parties, create the Code of Conduct which will be presented to the AMA HOD at its annual meeting in June. Founded in 1807, the Medical Society of the State of New York represents over 25,000 physicians, residents and medical students. Medical Society of the State of New York 99 Washington Avenue, Suite 408 Albany, NY 12210

Source: Business Wire

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