Medical Necessity

Resolution H00
Becomes Policy March 2000

AMDA resolves to open immediate dialogue with HCFA to urge elimination of statistical quotas by fiscal intermediaries as a means of determining medical necessity for physician visits in the long term care continuum; and be it further

RESOLVED, that AMDA should work closely with HCFA to promote AMDA's position statement on medical necessity for physicians visits in the long term care continuum; and be it further

RESOLVED, that AMDA should work with HCFA to develop an impartial appeals board to resolve disputes regarding medical necessity issues for each contractor (fiscal intermediary) utilizing physicians not directly employed by the contractor, and who are trained and practicing in LTC or geriatric medicine.