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Patients aren’t the only ones voicing concerns over the state of the US health insurance industry.
The American Medical Association’s (AMA) policymaking arm on Tuesday called for new oversight and standards that ensure health plans don’t improperly limit patient access to in-network care.
The AMA House of Delegates voted to establish and enforce health insurance network adequacy standards as it met in National Harbor, Maryland, this week. The body adopted the proposal—along with several others—as part of the AMA’s continued efforts to ensure health plans meet patient needs and are held accountable for narrow networks.
The association said inadequate networks can create difficulties for patients in need of new or continued care. They can further limit patient choice when it comes to who is able to treat them and where they can be treated.
“The AMA believes regulators must do better to ensure network adequacy to ensure patients have options in accessing care,” AMA President Jesse Ehrenfeld said in a statement. “The policy adopted today will help the AMA encourage a multilayered approach for regulatory oversight that includes meaningful standards, transparency of network breadth, parameters for out-of-network care, and effective monitoring and enforcement of existing standards.”
AMA officials further pledged to establish and enforce a minimum network adequacy standard for health plans given state variability in such oversight.