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How the AMA Undermines Doctors Ability to Negotiate Reimbursement Rates

Friday, February 03, 2012

D4PC has previously discussed how the American Medical Association (AMA) has subjugated the interests of its member-doctors (and the medical profession as a whole) in favor of protecting its government-granted CPT billing code monopoly. Dr. Daniel Palestrant writes about yet another way that the AMA is selling out doctors. This latest practice involves the collection and sale of data regarding doctors across the country.

The AMA compiles information about each doctor in the form of the AMA Physician Masterfile, which the AMA then licenses to the government, insurance companies, and third parties. This file uses "Medical Education Numbers" (or ME numbers) to categorize information about each doctor. Users of the Masterfile (such as insurance companies) are able to use this information to put the financial squeeze on doctors with respect to reimbursement rates.

As Dr. Palestrant points out: "the CPT codes and the ME numbers create information 'asymmetry' where one party in a transaction knows more than the counter-party. When one party in a transaction has more 'perfect' information, they always prevail.... The AMA’s CPT system, combined with their Physician Masterfile, has created the underpinnings of a bureaucracy that systematically undermines the ability of this country’s physicians to treat their patients." 

Read Dr. Palestrant's full commentary here.

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