AMA's contracting law database now includes federal laws
■ The National Managed Care Contract's data bank also contains state laws and Association policy and issue briefs.
By Emily Berry — Posted Dec. 20, 2010
The American Medical Association's National Managed Care Contract database now includes information about federal laws that govern contracting, in addition to the state-level guidance that has been available since the database launched in March. The database contains not only relevant state and federal statutes, searchable by keyword, but also AMA briefings on contracting issues and AMA policy related to the searched term.
The new federal law section, added in November, includes searchable statutes and regulations from the Federal Employees Health Benefits Act, the Employee Retirement Income Security Act, the Internal Revenue Code, the Public Health Service Act and the Health Insurance Portability and Accountability Act. Medicaid and Medicare rules also are available.
The tool is meant to be a resource for physicians and office staff who are negotiating contracts with health plans, considering setting up practice in a new state, or looking to ensure that contracts comply with state and federal laws.
The national contract database allows users to compare managed care contracting laws in as many as six states at a time.
The issue briefs in the database include guides to managed care contracting clauses that physicians should beware of, how to deal with medical necessity denials and appeals, how to determine preauthorization requirements and verify eligibility, and how to spot or avoid being part of a rental network.
The contract database is available to any AMA member.