The American Medical Association plans to fight health insurers' and health plans' post-procedure claim reviews in Congress.

AMA members at the Chicago-based group's voted Tuesday to adopt a policy that would block insurers and plans from denying payment for claims after approving procedures through prior authorization processes.

The vote came at the AMA's interim House of Delegates meeting in Orlando, Florida.
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Dr. Marilyn Heine, an AMA board member, said that, once insurers or plans authorize care, that should be enough to guarantee payment.

"It is unacceptable that a health plan gives a 'green light' to medically necessary care and then retains or creates barriers to payment," Heine said. "It's an affront to physicians, patients and employers, and leads to financial strains for practices and families."

In addition to lobbying for a federal ban on post-claim reviews of care that has already been authorized, the AMA plans to encourage physicians to sue insurers and plans that deny payments for care that has already been authorized or that try to get cash back from the physicians or patients.

The AMA House of Delegates has also been considering many other topics at the Orlando meeting, including strategies for getting physicians time and compensation for answering the messages sent to physicians through patient portal systems.