March 08, 2018

AMA and Anthem Jointly Address Physician Concerns

On March 2, the American Medical Association (AMA) sent an email message to the leaders of medical specialty societies announcing that it had worked with Anthem Insurance to draft a joint statement addressing growing physician concerns about the insurer’s new policies and guidelines.

The American College of Radiology (ACR) is pleased that the AMA’s message acknowledged the need for continued dialogue with Anthem regarding ongoing issues with “restrictions on advanced imaging in hospital outpatient facilities.”

On the heels of Anthem’s decision not be proceed with its controversial policy to reduce payments for evaluation and management (E&M) services reported with CPT modifier 25, the AMA stated:

“We believe that Anthem’s decision reflects the growing recognition of the need for a different type of dialogue and engagement between health plans and the physician community to improve health care quality, access and affordability.”

The ACR has expressed similar sentiments in its multiple communications with Anthem about the College’s opposition to the insurer’s recent policy to exclude hospital outpatient imaging as a site of service for its beneficiaries.

The ACR supports the AMA’s efforts to foster better communication with Anthem to achieve more productive policies for patients as well as physicians.