Colorado Medical Society

Introduced by: Arapahoe Douglas Elbert Medical Society

Subject: Requiring Insurance Companies to Disclose any Variation from AMA CPT Guidelines

Referred to: Reference Committee on Health Affairs

WHEREAS, the AMA CPT Code is the standard base for reimbursement used by Medicare for its fee schedule, and

WHEREAS, it is common practice for insurance companies to vary from the AMA CPT Guidelines when making reimbursements, therefore, be it

RESOLVED, that the Colorado Medical Society actively pursue legislation that would require insurance companies to disclose to physicians with whom they contract if they are going to vary their rules for payment from the standard AMA CPT rules, and that, if a fee schedule is changed during the contract period, the insurance company be required to send the changes to the physician, and be it further

RESOLVED, that the CMS Delegation to the AMA take to the AMA House of Delegates a resolution calling for federal legislation that would accomplish this same goal for physicians throughout the United States.

FISCAL IMPACT: None