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THIRD-PARTY PAYORS / REIMBURSEMENT
Harnessing Market Forces in Medical Pricing
RESOLVED, That the North Carolina Medical Society supports the following principles for incorporation in any public or private insurance proposal for physician payment:
- A Resource Based Relative Value Scale that is regularly updated and rigorously validated should form the basis for all physician fee schedules.
- Government programs and private insurers may establish fee schedules based upon a dollar conversion factor but physicians should not be required to accept this as payment in full unless they have freely entered into a contract to do so.
- Physicians should be free to set their own fees based upon a conversion factor determined solely by the physicians’ assessment of their overhead costs and the value of their services in the marketplace.
- The conversion factors of payors and physicians should be widely published and distributed so that consumers can choose physicians based upon economic factors and the perceived quality of a physician’s services.
(Substitute Resolution 1-1992, adopted 11/8/1992)
(revised, Report H-2002, adopted 11/17/2002)
(revised, Report N-2008, Item 3-52, adopted 10/19/2008)
(reaffirmed, Reaffirmation Report-2013, Item 67, adopted 10/26/2013)
(reaffirmed, Board Report-2018, Item 198, adopted 11/3/2018)