AMA Model Managed Care Contract: Know what you're signing

The Association updates its model contract, which gives physicians a resource they can use as they review their health plan deals.

Editorial. Aug. 1, 2005.

No matter who you talk to, the advice on signing a contract is the same -- don't sign anything until you've read it and understood it.

Reading is one thing, but understanding is another. The meanings of a contract's words aren't always as black and white as the paper on which they appear.

To give physicians a frame of reference in checking out their contracts, the American Medical Association since 1997 has published and updated what it calls the AMA Model Managed Care Contract. Recently, the AMA released its fourth and latest edition of the contract. It's but one of many tools available at the AMA's Private Sector Advocacy Web site, open to all physicians seeking assistance in getting some leverage in the generally lopsided negotiations between themselves and health plans.

The 66-page AMA Model Managed Care Contract gives physicians pointers on what language to look out for, especially seemingly innocent verbiage that could come to haunt physicians later. The basics of the model contract haven't changed significantly since the first edition was released, but the latest version includes tips and tweaks that reflect new ways in which plans try to angle a greater advantage over physicians.

For example, the latest version has a supplement that discusses rental networks, also known as silent PPOs. As PPOs themselves have grown more popular, so has a greater market for leasing physician networks to so-called networkers and repricers.