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1 AMERICAN MEDICAL ASSOCIATION HOUSE OF DELEGATES 2 3 4 Resolution: 224 5 (A-09) 6 7Introduced by: New Jersey Delegation 8 9Subject: Expanding Patients’ Legal Rights When Insurance Companies Deny Care 10 11Referred to: Reference Committee B 12 (Monica C. Wehby, MD, Chair) 13 14 15Whereas, Keeping healthcare costs down by requiring insurance company precertifications has 16a serious impact on the timely provision of care to sick patients; and 17 18Whereas, President Obama has said that “we can no longer put healthcare [delivery] reform on 19hold;” therefore be it 20 21RESOLVED, That our American Medical Association lobby for the passage of legislation that 22would permit legal causes-of-action by the insured against their healthcare insurers and their 23agents for: 24 25 a. damages caused when diagnostic tests and/or treatments are denied as “not 26 medically necessary,” when the denial of such tests and/or treatments result in 27 harm to the insured; and for 28 29 b. damages caused when diagnostic tests and/or treatments are denied as “not 30 covered,” when such tests and/or treatments are, in fact, covered, and the 31 denial of such tests and/or treatments results in harm to the insured. (Directive 32 to Take Action) 33 34Fiscal Note: Implement accordingly at estimated staff cost of $2,000. 35 36Received: 05/19/09