AMA Policies | Managed Care Contracting

AMA Policy

Third Party Payer Quantity Limits H-185.942

08/29/2023

ERISA-Med. Nec. Appeals-Deadlines, ERISA-Med. Nec. Decisions-Deadlines, State Medical Necessity Appeals-Deadlines, State Medical Necessity Decisions-Deadlines, Step Therapy Override, U.R. Criteria

AMA Policy

Delay in Payments Due to Disputes in Coordination of Benefits H-190.969

08/29/2023

Prompt Payment Deadlines

AMA Policy

Prohibiting Covenants Not-To-Compete in Physician Contracts H-265.988

08/29/2023

AMA Policy

Utilization Review, Medical Necessity Determination, Prior Authorization Decisions D-320.977

08/29/2023

U.R. Criteria

AMA Policy

Prior Authorization Reform D-320.982

09/02/2022

U.R. Criteria

AMA Policy

Preauthorization for Payment of Services H-320.961

09/02/2022

Retroactive Denial

AMA Policy

Prior Authorization Relief in Medicare Advantage Plans H-320.938

09/02/2022

Amendments, Retroactive Denial

AMA Policy

Medical Necessity and Utilization Review H-320.942

09/02/2022

U.R. Criteria

AMA Policy

Prospective Payment Model Best Practices for Independent Private Practice H-385.904

09/02/2022

Risk—Physicians Taking

AMA Policy

Hospital-Based Physician Contracting H-383.997

09/02/2022

Termination, Risk—Physicians Taking

AMA Policy

Medicare Physician Payment Reform D-390.961

09/02/2022

Risk—Physicians Taking

AMA Policy

Fair Reimbursement for Administrative Burdens D-320.978

09/02/2022

U.R. Criteria, Payment Edits

AMA Policy

Preauthorization D-320.988

09/02/2022

U.R. Criteria

AMA Policy

Prescription Drug Plans and Patient Access D-330.910

09/02/2022

U.R. Criteria

AMA Policy

Opposition to Prescription Prior Approval D-125.992

09/02/2022

U.R. Criteria