While Congress and President Barack Obama work on comprehensive health reform, an effort to force managed care companies to adhere to a code of conduct is gaining steam.

The Alliance for Patient Access has obtained the 1,000th signature for its initiative to get managed care companies to follow a National Health Insurer Code of Conduct, which is being drafted by the American Medical Association. The AMA, the largest doctors’ association in the nation, expects to approve a final draft of the code at its November meeting.

Among the signatories for the petition drive seeking managed-care changes are individuals, doctors and patient advocacy groups, who seek clear and concise principles to address both medical care policies and payment issues and concurrence among health insurers in complying with this code of conduct, according to the alliance. The petition being signed also proposes a mechanism to monitor compliance. Its core principles are transparency, clinical autonomy, corporate integrity, and most importantly, patient access and safety.

The code is designed to address the “aggressive cost-cutting tactics used by the managed care industry,” according to the alliance. Tactics such as therapeutic substitution and fail-first policies can cause undue suffering to patients and interfere with the integrity of the doctor-patient relationship, the group said, noting that the managed care industry is the only sector of the healthcare industry lacking a code of conduct or code of ethics.

David Charles

“Strong support for this petition underscores the fact that physicians are frustrated when managed care companies interfere in the care of their patients,” said alliance chairman David Charles. “I am particularly encouraged by the timely growth of our petition because it shows that doctors, patients, and advocacy groups are banding together to support the need for an Insurer Code of Conduct.”

Resolution 823, Health Insurance Code of Conduct, was originally adopted by the AMA’s House of Delegates after being introduced by the New York delegation at the 2008 AMA interim meeting in November. At the June AMA meeting in Chicago, Dr. Joseph Heyman presented a report on the initiative from the AMA board of trustees.

The report notes a new sense of urgency to address physician and patient frustrations with health insurers citing examples state legislatures working to provide physician and patient relief from unfair managed care practices. Specifically, the report cites Indiana House Resolution 91, passed in June, which encourages the AMA to develop a Health Insurer Code of Conduct, as well as the Health Insurance Code of Conduct Act of 2009, sponsored by the Texas Medical Association, which is being considered by the Texas legislature [Senate Bill 1257 and House Bill 2750, respectively].