Health Information Compliance Alert

Published on Sun Feb 28, 2010 PDF

NMCC & accompanying database to provide necessary assistance.

Finally, there's an online resource for physicians seeking respite from the one-sided contracts offered by some managed care organizations.

According to a March 16 post on the AMAWeb site, the American Medical Association (AMA) launched National Managed Care Contract (NMCC) and database, which is model contract language (complying with managed care laws of all 50 states and the District of Columbia) to help physicians analyze and negotiate contracts with insurers and protect them from unfair corporate business practices.

"The concentrated market power of large health insurers gives them an unprecedented advantage in dictating key aspects of healthcare to physicians," AMA president J. James Rohack, MD, was reported in the post as saying. "The AMA's new resources will be a welcome guide for negotiating fair contracts with health plans angling for an even greater advantage over physicians."

Physicians who use this online bundled service will be provided with a frame of reference to compare and evaluate prospective managed care contracts. According the article on the AMAWeb site, the NMCC is an attempt by the Chicago-based AMA to create model contract language and to comprehensively cover the broad range of physician concerns with managed care contracts.

Also, the keyword-searchable database associated with the NMCC provides users with easy access to updated statutes and regulations. This database also covers details of the managed care contracting process, the managed care contract itself, and the business relationship between physicians and managed care organizations after an agreement has been signed.

According to the post on the AMAWeb site, the database provides alternative contract language, ensures contracts' and payers' compliance with state requirements, clarifies contract issues and manages ongoing relationships, monitors emerging state and federal legislative and regulatory trends, and assists with advocacy efforts to reform unfair business practices.

AMA does say in the post though that NMCC is not designed to take the place of competent, individualized legal advice.

(Editor's note: The post on the AMAWeb site can be read at: www.ama-assn.org/ama/pub/news/news/managed-care-contract-tool.shtml. AMA members can access the NMCC and database at www.ama-sn.org/go/nationalcontract.)