If passed, the ACR-led resolutions will direct the AMA to advocate for state-level pharmacy benefit manager reform and to fix broken Medicare Administrator Contractor processes. Several other specialties joined the ACR’s resolutions as supporting cosponsors.
Audit activity among Medicare and most third-party payers has increased in response to pressure to reduce healthcare costs. The return of billions of dollars to Medicare, Medicaid and third-party programs through these medical audit reviews has also increased. For example, the Government Accountability Office (GAO) 2014 Annual Report estimated that the Centers for Medicare &…