The AMA advocates for America's physicians before Congress and the administration in Washington, D.C. The AMA is committed to addressing the ongoing problems and burdens in the practice revenue cycle—problems that contribute to increased complexity and expense for physicians.
The AMA advocates on physicians’ behalf in a number of arenas to reduce the administrative hassles associated with securing health plan payments.
Visit the Federal and State Correspondence Finder to read the background of the AMA’s efforts in this area.
The National Committee on Vital and Health Statistics (NCVHS) is a federal advisory body charged with making recommendations pertaining to electronic health care transaction standards and administrative simplification to the U.S. Department of Health and Human Services (HHS).
The AMA has provided extensive testimony to NCVHS to ensure physicians’ interests in fully automating their practices are represented. Elimination of the manual processes and current administrative burden can only occur if NCVHS adopts standards that meet the needs of all stakeholders, rather than just the interests of health plans. The following is a selection of pertinent AMA testimony and presentations given to NCVHS on various administrative simplification issues:
NCVHS Subcommittee on Standards: Hearing on CAQH-CORE Proposed Operating Rules—Aug. 25-26, 2020
- Oct. 2020 - Joint follow-up letter to Aug. 25 NCVHS hearing (PDF)
- Aug. 2020 - NCVHS hearing on CAQH-CORE proposed operating rules (PDF)
- Aug. 2020 - NCVHS Subcommittee on Standards: CAQH-CORE prior authorization operating rules presentation (PDF)
- Aug. 2020 - NCVHS Subcommittee on Standards: CAQH-CORE connectivity operating rules presentation (PDF)
NCVHS Subcommittee on Standards: Hearing on Health Care Claims Operating Rules—Feb. 16, 2016
- Feb. 16, 2016 - NCVHS hearing on health care claims (PDF)
- Feb. 16, 2016 - NCVHS hearing on prior authorization rules (PDF)
- Feb. 16, 2016 - Prior authorization slideshow (PDF)
- Feb. 16, 2016 - NCVHS hearing on mandatory submission of supporting clinical documentation (PDF)
- Feb. 16, 2016 - Attachment standard written testimony presentation slides (PDF)
NCVHS Subcommittee on Standards: Review Committee—June 16–17, 2015
- June 2015 - NCVHS hearing on adopted transaction standards, operating rules, code sets & identifiers (PDF)
- June 2015 - Presentation for the NCVHS hearing on prior authorization (PDF)
- June 2015 - NCVHS hearing on ERA/EFT (PDF)
- Nov. 13, 2019 - NCVHS Full committee meeting: Expert panel on prior authorization slides (PDF)
- May 3, 2017 - NCVHS Subcommittee on Standards: Health plan identifier testimony (PDF)
- May 3, 2017 - NCVHS Subcommittee on Standards: Health plan identifier joint presentation slides (PDF)
- Feb. 26, 2015 - NCVHS Subcommittee on Standards: CAQH-CORE operating rules (PDF)
- Feb. 26, 2015 - NCVHS Subcommittee on Standards: Review committee (PDF)
- June 10, 2014 - Virtual credit card update (PDF)
- Feb. 19, 2014 - Virtual credit cards (PDF)
- Feb. 19, 2014 - Pharmacy prior authorization (PDF)
The AMA Advocacy Resource Center (ARC) works hand-in-hand with state and specialty medical societies on state-level efforts to alleviate practice burdens and promote efficient revenue processes. The AMA has produced several pieces of model legislation that can be used by state legislatures to achieve administrative simplification, including bills addressing prior authorization and electronic payments from health insurers. For additional information, please visit the AMA model bills page.
In addition to NCVHS and state advocacy, the AMA has promoted revenue cycle improvements to other relevant industry outlets.
- Letter to CMS on virtual credit cards and EFT standard (PDF)
- Letter to HHS on virtual credit card concerns (PDF)
- Letter to CMS on virtual credit cards and health plan identifiers (PDF)
- Letter to HHS on Electronic Attachment Standard (PDF)
The AMA administrative simplification LinkedIn group is designed to provide updates and encourage dialogue on administrative issues affecting physician practices, including automation using electronic standards and operating rules, prior authorization standardization and reform, and regulatory developments. Physicians, practice staff and other interested stakeholders are encouraged to join.