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



Source: Alliance for Patient Access