You should be aware of any harmful business practices undertaken by the insurers with whom you contract. In addition, it’s useful to know what sort of business practices can be brought to the attention of, and redressed by, your state’s regulatory agencies. Even if your practice hasn’t experienced such unfair payer activities in the past, it is always best to be prepared for the future.
Refer to the AMA’s, “Report of health insurer fines issued by state regulatory agencies,” for a comprehensive table detailing enforcement actions taken against payers. This report collects vital information including:
- the state and agency issuing the fine
- the company being fined
- the amount fined/paid
- the date the fine was issued
- an explanation of the reasons for the fine
This resource is current as of April 30, 2010, and reflects data on fines issued between December 2007 and December 2009.
Empower your practice with the National Managed Care Contract (NMCC)
Take advantage of this comprehensive managed care contracting resource to look up all the managed care laws and regulations in your state, as well as issue briefs on key managed care topics.
Developed by the AMA and state medical association attorneys with expertise in managed care contracting issues and regulations, the National Managed Care Contract includes more than 70 pages of model provisions based on state law and thousands of pages reflecting every managed care law and regulation in the country.