On-Line Petition Launched in Support of a National Health Insurer Code of Conduct

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Mon Apr 20, 2009 9:00am EDT

Code Would Require Greater Focus on Transparency, Clinical Autonomy, Corporate
Integrity and Patient Safety and Welfare
MACON, Ga.--(Business Wire)--
In an effort to ensure and protect patient access to approved medical
treatments, a petition in support of a Health Insurer Code of Conduct was
launched today by the Alliance for Patient Access (AfPA). The petition calls for
the adoption of a Code of Conduct, currently being drafted by the American
Medical Association, which will address restrictive practices of the managed
care industry which undermine the integrity of doctor-patient relationships. 

The AMA House of Delegates passed a resolution in November of 2008 to draft and
adopt a National Health Insurer Code of Conduct. According to the resolution,
the AMA code will set forth clear and concise principles addressing both medical
policies and payment issues, as well as create a mechanism to monitor compliance
by managed care companies. 

Currently, while many managed care organizations maintain appropriate focus on
quality measures, some managed care plans and pharmacy benefit managers employ
aggressive tactics to cut costs, while at the same time shifting blame for
consequences of actions such as premium increases and cost-sharing strategies
onto other parties in the healthcare industry. 

"In Georgia, the cost-control efforts implemented by managed care health plans
have created the widespread perception that such plans are more interested in
saving money than providing quality health care," said Dr. Christina Mayville, a
neurologist in Macon, GA. "Unlike many other stakeholders in the health care
industry, however, there is no overarching standard of conduct for health plans.
The Alliance for Patient Access is taking the lead to collect support for a Code
of Conduct to empower health plans to voluntarily agree to abide by principled
guidelines and specific protocols regarding certain issues that are particularly
prone to abuse." 

AfPA`s petition calls for autonomy between doctors and managed care companies,
as well as full transparency regarding a patient`s prescribed course of care.
This includes any relationships with outside parties that might influence
doctors` decisions. AfPA also calls for upholding business integrity, with fees
reflecting acceptable rates and prescribed courses of treatment resulting from
medically-based, not fiscally-driven, decisions. Finally, AfPA`s first priority
remains patients` access to quality medical care that ensures their safety and
welfare. 

"A Code of Conduct for the managed care industry is highly overdue," said Dr.
David Charles, AfPA Chairman. "The petition is a way for us to show managed care
companies that we will not stand by as they attempt to interfere with the course
of treatment prescribed to patients by their doctors. A Health Insurer Code of
Conduct will help protect patients by regulating the practices of managed care
companies and holding them accountable to the same standards to which the rest
of the healthcare industry already adheres." 

The American Medical Association (AMA) passed a resolution in November 2008 to
adopt a Health Insurer Code of Conduct, which it is currently drafting. The AMA
will vote to adopt the code in June. 

The AfPA petition for a Health Insurer Code of Conduct can be found at
www.insurepatientaccess.org. 

AfPA is a national network of over 250 physicians with the shared mission of
ensuring and protecting patient access to approved medical treatments and
therapies, including prescription pharmaceuticals, biologics, and medical
devices. AfPA accomplishes this mission through educating members on policy
priorities and training them to be effective patient advocates. Specifically,
AfPA recruits and trains health policy-minded physicians to be effective
advocates at a local, state and federal level, and then facilitates
communications between them as they promote pro-access health policy. AfPA`s
policy agenda is focused on global health policy issues including: comparative
effectiveness, therapeutic substitution, prescriptive authority, evidence-based
medicine, bio-similar safety, and health access disparities. 

Dr. Mayville is a board certified neurologist practicing in a dedicated single
specialty group committed to providing comprehensive, high-quality care. She
graduated from Mercer University School of Medicine and completed residency in
Neurology and Fellowship in Clinical Neurophysiology at Vanderbilt University
Medical Center. 





For Alliance for Patient Access:
Sealy Livermore, 212-446-1873
Slivermore@sloanepr.com



Copyright Business Wire 2009

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