The American Medical Association

In: Business and Management

Submitted By juli1605
Words 712
Pages 3
The American medical association- Homework week 7. 6/10/12

The American medical association (or AMA) is the largest association of medical doctors and medical students in the United States. The AMA has a lot of missions, between them to promote the art and science of medicine for the betterment of the public health, to advance the interests of physicians and their patients, to promote public health, to lobby for legislation favorable to physicians and patients, and to raise money for medical education. The association believes in Usual, Customary and Reasonable Payments and in this paper we will notice some of the cases that AMA is involved with.
In the first case, we can see the AMA, several state medical societies and two individual doctors are suing Aetna health and its various subsidiaries. The complaint was about Aetna miscalculated the amounts that were paid to out of network doctors. The problem appeared on the two databases that are used by Aetna and showed that it was a violation of ERICA, RICO and Sherman Antitrust act. The case was managed in the Florida court as well as in New Jersey court. Both sides were working with mediator in order to negotiate between the sides; however, unfortunately the mediator died and as it seems now the future of the negotiation is uncertain.
In this case AMA as well as several patients is against CIGNA. AMA claiming (like in the previous case) that CIGNA miscalculated the payments to the out of the network doctors, which was found in theirs two data bases. The violation appears as same as in the previous case. The case was managed in New Jersey court but was moved to the court of Georgia. The reason was because the New Jersey court dismissed most of the claims, while the Georgia court is believed to be more favorable. For now, the court is discussing settlements between the sides.
In the third case,…...

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