Tag: American Medical Association (AMA)
Inspire Medical receives CPT code approval for Inspire V
October 7, 2026HME News Staff
MINNEAPOLIS – Inspire Medical Systems has announced that the American Medical Association (AMA) CPT Editorial Panel has approved a new set of Current Procedural Terminology (CPT) codes that accurately describe and include the Inspire V system. The new Category I codes are scheduled to take effect on Jan. 1, 2028. “This new CPT code language addresses the implantation of a single lead and an implantable pulse generator (IPG) including our recently launched Inspire V system,” said...
AMA analysis: PBM market concentration continues to rise
September 30, 2026HME News Staff
CHICAGO – A small number of pharmacy benefit managers (PBMs) account for an increasingly large share of the national market, according to the American Medical Association’s (AMA) annual analysis.
The top four PBMs collectively had 75% share of the national-level PBM market in 2024, an increase from 70% in 2022, according to the analysis.
“Competitive PBM and prescription drug plan markets help patients get the medications they need at a fair price,” said AMA President...
AMA survey finds barriers to wearable data adoption
July 9, 2026HME News Staff
CHICAGO – While interest in wearable health technologies is high, their integration into routine clinical care continues to be limited by workflow, reimbursement and trust issues, according to a new international survey from the American Medical Association (AMA). The 2026 International Physician Survey on Consumer Wearables, conducted by the AMA’s Center for Digital Health and AI and Medscape, surveyed 2,222 physicians in the United States, Canada, France, Germany, Spain and the United...
AMA announces educational video series on caring for people with disabilities
May 13, 2026HME News Staff
CHICAGO – The American Medical Association (AMA) has announced a collaboration with the University of Colorado Anschutz on a new educational video series to help physicians and medical students provide high-quality, patient-centered care for people with disabilities. The Caring for People with Disabilities Series is free and available on AMA Ed Hub, AMA’s online learning platform. “The AMA and physicians everywhere want all patients to receive the best possible care – and...
AMA urges Congress to make telehealth changes permanent
January 7, 2026HME News Staff
WASHINGTON – The American Medical Association (AMA) is urging Congress to enact permanent authorization of Medicare telehealth services and end the repeated cycle of temporary extensions that have undermined reliable access to virtual care.
The current Medicare telehealth waiver expires on Jan. 30.
“Since the COVID-19 public health emergency, Congress has repeatedly extended telehealth flexibilities for Medicare patients—often...
AMA: PBM markets are at risk of harming patients
July 31, 2025HME News Staff
CHICAGO – Pharmacy benefit managers had little competition in 2023, with just four firms having two-thirds share of the national market, according to a new annual analysis published by the American Medical Association (AMA).
The analysis, based on 2022 and 2023 data on prescription drug plan (PDP) enrollees, measures competition in PBM markets and vertical integration of insurers with PBMs. The assessment demonstrates low competition in PBM markets across the nation and high vertical...
AMA supports MedPAC on payment update
January 20, 2025HME News Staff
WASHINGTON – The American Medical Association supports a recommendation from MedPAC to link next year’s physician payment update to the growth in the cost of providing care. MedPAC recently voted to recommend a 2026 payment update of Medicare Economic Index minus 1%, slightly adjusting the formula it endorsed last year to increase payment by 50% of MEI. “While neither recommendation covers the estimated inflation that physician practices face, both approaches embrace the fact that...
AMA works to right-size prior auths
November 12, 2024HME News Staff
ORLANDO, Fla. – The American Medical Association will consider legislative and legal actions to fight retrospective denial of payment for care that has been pre-certified by an insurer.
A 700-member House of Delegates has approved a new policy that directs the AMA to support a federal prohibition on the inappropriate denial of payment for medically necessary care that has been pre-certified by insurers and encourages the association to take legal action against insurers that engage...
AMA seeks greater oversight of MA plans
June 11, 2024HME News Staff
CHICAGO – Physician and medical student leaders at the Annual Meeting of the American Medical Association (AMA) House of Delegates approved policies to address the need for greater oversight of health insurers’ use of prior authorization controls on patient access to care. The new policies address insurer accountability and transparency for PA denials. “Waiting on a health plan to authorize necessary medical treatment is too often a hazard to patient health,” said AMA...
AMA calls for AI oversight
June 20, 2023HME News Staff
CHICAGO – The American Medical Association has adopted a new policy calling for greater regulatory oversight of health insurers using artificial intelligence (AI) to review patient claims and prior authorization requests. The newly adopted policy calls for health insurers using AI to implement a thorough and fair process that is based on clinical criteria and reviews by physicians and other health care professionals with expertise for services under review, and that has no incentive to deny...