{"id":2723,"date":"2026-06-15T21:00:39","date_gmt":"2026-06-15T21:00:39","guid":{"rendered":"https:\/\/drsoniafawad.com\/?p=2723"},"modified":"2026-06-15T21:00:39","modified_gmt":"2026-06-15T21:00:39","slug":"ama-calls-for-ai-regulations-in-clinics-insurance","status":"publish","type":"post","link":"https:\/\/drsoniafawad.com\/?p=2723","title":{"rendered":"AMA calls for AI regulations in clinics, insurance"},"content":{"rendered":"<p><br \/>\n<\/p>\n<div data-component=\"ArticleContent\">\n<div class=\"article__below-title\">\n<div class=\"mobile-trust-box\">\n<div class=\"row\">\n<div class=\"col-12 col-md-6 offset-md-1 offset-xl-0 col-xl-12\">\n<div class=\"email-alert-button-wrapper d-none\" data-component=\"EmailTopicAlert\" data-module=\"Subspecialty Email Topic Alerts Top\" data-manage-email-link=\"\/footer\/account-information\/my-account\/email-subscriptions-and-alerts#emailAlerts\">\n  <hidden data-setting-item=\"d265901d-6d37-49c7-a8f6-c7bf19a02509\"\/><br \/>\n  <hidden data-crm-source=\"Subspecialty Topic Alert\"\/><\/p>\n<div class=\"email-alert-button d-none\" data-topic-button=\"not-subscribed\">\n<p>&#13;<br \/>\n      <span data-module-track-action=\"Email Alerts TOP_Click_Healio News Article\" data-module-track-label=\"Email Alerts TOP_Healio News Article\">&#13;<br \/>\n        <i class=\"fas fa-plus-circle\"\/>&#13;<br \/>\n        Add topic to email alerts&#13;<br \/>\n      <\/span>&#13;\n    <\/p>\n<div class=\"email-alert-inner collapse u6f5bcdfb65d149d4a2752ea2e7528a7b\">\n<div class=\"email-alert-dialogue\">\n<p>&#13;<br \/>\n          Receive an email when new articles are posted on <span data-content=\"topic-title\"\/>&#13;\n        <\/p>\n<div class=\"d-none\" data-sign-up-type=\"unknown\">\n          Please provide your email address to receive an email when new articles are posted on <span data-content=\"topic-title\"\/>.<\/p><\/div>\n<\/p><\/div>\n<p>      <button type=\"button\" class=\"btn btn-primary\" data-loading-text=\"Loading &lt;i class=\" fa=\"\" fa-spinner=\"\" fa-spin=\"\">&#8220;&#13;<br \/>\n              data-action=&#8221;subscribe&#8221;&gt;&#13;<br \/>\n        Subscribe&#13;<br \/>\n      <\/button>\n    <\/div>\n<\/p><\/div>\n<div class=\"d-none\" data-topic-modal=\"failed\">    <strong>We were unable to process your request. Please try again later. If you continue to have this issue please contact <a href=\"https:\/\/www.healio.com\/news\/primary-care\/20260611\/mailto:customerservice@slackinc.com\">customerservice@slackinc.com<\/a>.<\/strong>  <\/p>\n<p><button data-dismiss=\"modal\" class=\"btn btn-primary btn-lg btn-block\">Back to Healio<\/button><\/p>\n<\/div>\n<\/div><\/div>\n<\/p><\/div>\n<\/p><\/div>\n<\/div>\n<h2>Key takeaways:<\/h2>\n<ul>\n<li>At its annual meeting, the AMA adopted new policies stressing the need for physician oversight.<\/li>\n<li>They also advocate for more transparency when AI is used in both clinical and in health insurance decision-making.<\/li>\n<\/ul>\n<p>The AMA adopted new AI policies in a bid to ensure that the technology supports evidence-based medicine, bolsters patient care and serves under a physician\u2019s oversight, instead of replacing their discernment.<\/p>\n<p>According to an AMA press release, AI technologies <a rel=\"noopener noreferrer\" href=\"https:\/\/www.healio.com\/news\/orthopedics\/20260609\/ai-scribes-may-have-profound-impact-on-patient-care\" id=\"rId13\" target=\"_blank\">could help with efficiency<\/a> and synthesizing information, but there are still <a rel=\"noopener noreferrer\" href=\"https:\/\/www.healio.com\/news\/primary-care\/20251211\/qa-new-ama-policy-seeks-to-combat-the-danger-of-deepfake-doctors\" id=\"rId14\" target=\"_blank\">important concerns<\/a> for bias, long-term impact on both physicians and patient outcomes, explainability and transparency.<\/p>\n<figure class=\"figure article__og-image\">&#13;\n    <picture>&#13;<source srcset=\"https:\/\/www.healio.comhttps:\/\/www.healio.comhttps:\/\/www.healio.com\/~\/media\/slack-news\/ophthalmology\/misc\/stock-art\/technology_3.webp?w=476\" media=\"(max-width: 768px)\">&#13;<source srcset=\"https:\/\/www.healio.com\/~\/media\/slack-news\/ophthalmology\/misc\/stock-art\/technology_3.webp?w=800\" media=\"(max-width: 992px)\">&#13;<source srcset=\"https:\/\/www.healio.com\/~\/media\/slack-news\/ophthalmology\/misc\/stock-art\/technology_3.webp?w=595\" media=\"(max-width: 1200px)\">&#13;<source srcset=\"https:\/\/www.healio.comhttps:\/\/www.healio.comhttps:\/\/www.healio.com\/~\/media\/slack-news\/ophthalmology\/misc\/stock-art\/technology_3.webp?w=476\" media=\"(min-width: 1200px)\">&#13;<source srcset=\"https:\/\/www.healio.comhttps:\/\/www.healio.comhttps:\/\/www.healio.com\/~\/media\/slack-news\/ophthalmology\/misc\/stock-art\/technology_3.webp?w=476\">&#13;<br \/>\n&#13;<br \/>\n      <img decoding=\"async\" src=\"https:\/\/www.healio.com\/~\/media\/slack-news\/ophthalmology\/misc\/stock-art\/technology_3.jpg?w=800\" alt=\"Eye with projections\" class=\"figure-img img-fluid\" width=\"800\"\/>&#13;<br \/>\n    <\/source><\/source><\/source><\/source><\/source><\/picture>&#13;<figcaption class=\"figure-caption\">&#13;<br \/>\n      At its annual House of Delegates meeting, the AMA adopted new AI-related policies. <em>Image: Adobe Stock<\/em>&#13;<br \/>\n    <\/figcaption>&#13;<br \/>\n  <\/figure>\n<p>These new policies, which address AI\u2019s growing popularity in both the clinical and health insurance decision-making realms, emphasize that AI should <a rel=\"noopener noreferrer\" href=\"https:\/\/www.healio.com\/news\/hematology-oncology\/20251112\/physicians-aim-to-maintain-decisionmaking-partnership-alongside-ai\" id=\"rId15\" target=\"_blank\">only be used as an assistive tool<\/a>, rather than \u201can autonomous decision-maker,\u201d according to the release. The policies also call for accountability, transparency and oversight from physicians every time AI is used in patient care.<\/p>\n<p>\u201cAI has enormous potential in health care, but it <a rel=\"noopener noreferrer\" href=\"https:\/\/www.healio.com\/news\/primary-care\/20260122\/integrating-medical-records-with-ai-a-watershed-moment-in-medicine-is-it-dangerous\" id=\"rId16\" target=\"_blank\">cannot replace physician judgment<\/a><b>,\u201d John Whyte, MD, MPH,<\/b> CEO of the AMA, said in the release. \u201cPatients deserve care decisions that are informed by the latest medical evidence and guided by a physician who understands their individual needs. Whether AI is helping a physician make a clinical decision or assisting with an insurance review, there must always be transparency, accountability and meaningful physician oversight. Technology should support better care \u2014 not stand between patients and the care they need.\u201d<\/p>\n<p>The AMA has said it will work with key stakeholders \u2014 including regulators, medical specialty societies and AI developers \u2014 to create standards for evidence transparency, evaluation, attribution, validation and explainability in systems that support clinical decision-making. This is in the hope of ensuring AI tools \u201creflect the principles of evidence-based medicine and provide physicians with information they can understand, evaluate and trust,\u201d according to the release.<\/p>\n<p>Another AMA policy calls for regulations to guarantee that health coverage decisions \u2014 which are increasingly based on AI, according to the release \u2014 are reviewed by physicians in appropriate fields with a foundation of evidence-based, up-to-date medical information.<\/p>\n<p>The policy additionally called for safeguards requiring AI technologies be integrated into a physician-led process and increased transparency when AI is involved in prior authorization decisions, including the disclosure of any guidelines, data sources or clinical logic used in adverse decisions. In this vein, the AMA is advocating for regular audits of clinical review tools driven by AI to help strengthen accountability. That also includes audits triggered by \u201csignificant changes to\u201d training data, clinical guidelines or AI models themselves, \u201cas well as comprehensive annual reviews to ensure continued alignment with standards of care,\u201d according to the release.<\/p>\n<p>\u201cWhen health plans use AI-driven tools to deny or delay care without explaining how those decisions were reached, physicians and patients are left in the dark,\u201d Whyte said in the release. \u201cAI should never function as an unaccountable black box. Health plans must be transparent about how these tools work, what evidence and data sources they rely on, and whether a qualified physician reviewed the decision.\u201d<\/p>\n<div class=\"article__content--footer\">\n<div class=\"perspective\">\n    <a id=\"E771C5A9004E41CC85CB9C1E30943315\"\/><br \/>\n    <a id=\"perspective\" name=\"perspective\"\/><\/p>\n<h2 class=\"title\">Perspective<\/h2>\n<p>    <a class=\"back-to-top\" href=\"#top\">Back to Top <i class=\"far fa-arrow-up\"\/> <\/a><\/p>\n<div class=\"perspective-body\">\n<p>The idea that AI should \u201csupport, not replace\u201d physician judgment is not controversial. It\u2019s obvious. The real issue is that, across health systems today, we are already drifting in the opposite direction \u2014 quietly, incrementally and often without enough oversight. AI tools are being embedded into workflows, influencing decisions and shaping clinical behavior faster than governance models can keep up. How many physicians are actually aware that they are using AI?<\/p>\n<p>The greatest risk is not that AI will replace physicians overnight. It\u2019s that it will subtly erode clinical judgment through automation bias, opaque recommendations and overreliance on systems that clinicians neither fully understand nor control. In that sense, the danger is not disruption, it\u2019s complacency. <\/p>\n<p>What the AMA policy stops short of saying explicitly is this: physician oversight alone is not enough. Oversight without infrastructure, governance and accountability is performative. Health systems need enterprise-level AI operating models \u2014 clear standards for validation, monitoring and lifecycle management \u2014 because fragmented, point-solution AI adoption is already creating measurable clinical and operational risk.<\/p>\n<p>Deepti Pandita, MD, FACP, FAMIA<\/p>\n<p>University of California Irvine Health<\/p>\n<p>&#13;<br \/>\n          <strong> Disclosures: <\/strong> Pandita reports no relevant financial disclosures.&#13;\n        <\/p>\n<\/p><\/div>\n<\/p><\/div>\n<div class=\"sources-references-disclosures\">\n<h3>Sources\/Disclosures<\/h3>\n<h2> Source: <\/h2>\n<p class=\"citation\">&#13;<br \/>\n  <a href=\"https:\/\/www.ama-assn.org\/press-center\/ama-press-releases\/ama-policies-ensure-ai-supports-not-replaces-physician-judgment\" id=\"rId17\" target=\"_blank\">Press Release<\/a>&#13;\n<\/p>\n<div class=\"disclosures\">\n<p>&#13;<br \/>\n        <strong> Disclosures: <\/strong>&#13;<br \/>\n        Whyte reports being CEO of the AMA.&#13;\n      <\/p>\n<\/p><\/div>\n<\/div>\n<p><!-- Healio AI Widget --><\/p>\n<div class=\"healio-ai-component-inline\" data-no-ads=\"true\" data-module-track-category=\"Healio AI\" data-module-track-action=\"Click\" data-module-track-label=\"Access Healio Ai from component - News_AI Component - In-Content (all devices)\">\n<div class=\"healio-ai-content\">\n    <img decoding=\"async\" src=\"https:\/\/m3.healio.com\/~\/media\/images\/healio-ai\/healio-ai_logo.svg\" alt=\"Healio AI\" class=\"healio-ai-logo\"\/><\/p>\n<p><strong>Ask a clinical question<\/strong> and tap into <strong>Healio AI&#8217;s knowledge<\/strong> base.<\/p>\n<ul>&#13;<\/p>\n<li>PubMed, enrolling\/recruiting trials, guidelines<\/li>\n<p>&#13;<\/p>\n<li>Clinical Guidance, Healio CME, FDA news<\/li>\n<p>&#13;<\/p>\n<li>Healio&#8217;s exclusive daily news coverage of clinical data<\/li>\n<p>&#13;\n    <\/ul>\n<p>    <button class=\"healio-ai-button\" onclick=\"window.location.href=\" https:=\"\">Learn more<\/button>\n  <\/div>\n<\/div>\n<div class=\"email-alert-button-wrapper d-none\" data-component=\"EmailTopicAlert\" data-module=\"Subspecialty Email Topic Alerts Top\" data-manage-email-link=\"\/footer\/account-information\/my-account\/email-subscriptions-and-alerts#emailAlerts\">\n  <hidden data-setting-item=\"d265901d-6d37-49c7-a8f6-c7bf19a02509\"\/><br \/>\n  <hidden data-crm-source=\"Subspecialty Topic Alert\"\/><\/p>\n<div class=\"email-alert-button d-none\" data-topic-button=\"not-subscribed\">\n<p>&#13;<br \/>\n      <span data-module-track-action=\"Email Alerts TOP_Click_Healio News Article\" data-module-track-label=\"Email Alerts TOP_Healio News Article\">&#13;<br \/>\n        <i class=\"fas fa-plus-circle\"\/>&#13;<br \/>\n        Add topic to email alerts&#13;<br \/>\n      <\/span>&#13;\n    <\/p>\n<div class=\"email-alert-inner collapse u6f5bcdfb65d149d4a2752ea2e7528a7b\">\n<div class=\"email-alert-dialogue\">\n<p>&#13;<br \/>\n          Receive an email when new articles are posted on <span data-content=\"topic-title\"\/>&#13;\n        <\/p>\n<div class=\"d-none\" data-sign-up-type=\"unknown\">\n          Please provide your email address to receive an email when new articles are posted on <span data-content=\"topic-title\"\/>.<\/p><\/div>\n<\/p><\/div>\n<p>      <button type=\"button\" class=\"btn btn-primary\" data-loading-text=\"Loading &lt;i class=\" fa=\"\" fa-spinner=\"\" fa-spin=\"\">&#8220;&#13;<br \/>\n              data-action=&#8221;subscribe&#8221;&gt;&#13;<br \/>\n        Subscribe&#13;<br \/>\n      <\/button>\n    <\/div>\n<\/p><\/div>\n<div class=\"d-none\" data-topic-modal=\"failed\">    <strong>We were unable to process your request. Please try again later. If you continue to have this issue please contact <a href=\"https:\/\/www.healio.com\/news\/primary-care\/20260611\/mailto:customerservice@slackinc.com\">customerservice@slackinc.com<\/a>.<\/strong>  <\/p>\n<p><button data-dismiss=\"modal\" class=\"btn btn-primary btn-lg btn-block\">Back to Healio<\/button><\/p>\n<\/div>\n<\/div><\/div>\n<\/p><\/div>\n<p><br \/>\n<br \/><a href=\"https:\/\/www.healio.com\/news\/primary-care\/20260611\/it-cannot-replace-physician-judgment-ama-calls-for-ai-regulations-in-clinics-insurance\">Source link <\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>&#13; &#13; &#13; Add topic to email alerts&#13; &#13; &#13; Receive an email when new articles are posted on &#13; Please provide your email address to receive an email when new articles are posted on . &#8220;&#13; data-action=&#8221;subscribe&#8221;&gt;&#13; Subscribe&#13; We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com. Back to Healio Key takeaways: At its annual meeting, the AMA adopted new policies stressing the need for physician oversight. They also advocate for more transparency when AI is used in both clinical and in health insurance decision-making. The AMA adopted new AI policies in a bid to ensure that the technology supports evidence-based medicine, bolsters patient care and serves under a physician\u2019s oversight, instead of replacing their discernment. According to an AMA press release, AI technologies could help with efficiency and synthesizing information, but there are still important concerns for bias, long-term impact on both physicians and patient outcomes, explainability and transparency. &#13; &#13;&#13;&#13;&#13;&#13;&#13; &#13; &#13; &#13;&#13; At its annual House of Delegates meeting, the AMA adopted new AI-related policies. Image: Adobe Stock&#13; &#13; These new policies, which address AI\u2019s growing popularity in both the clinical and health insurance decision-making realms, emphasize that AI should only be used as an assistive tool, rather than \u201can autonomous decision-maker,\u201d according to the release. The policies also call for accountability, transparency and oversight from physicians every time AI is used in patient care. \u201cAI has enormous potential in health care, but it cannot replace physician judgment,\u201d John Whyte, MD, MPH, CEO of the AMA, said in the release. \u201cPatients deserve care decisions that are informed by the latest medical evidence and guided by a physician who understands their individual needs. Whether AI is helping a physician make a clinical decision or assisting with an insurance review, there must always be transparency, accountability and meaningful physician oversight. Technology should support better care \u2014 not stand between patients and the care they need.\u201d The AMA has said it will work with key stakeholders \u2014 including regulators, medical specialty societies and AI developers \u2014 to create standards for evidence transparency, evaluation, attribution, validation and explainability in systems that support clinical decision-making. This is in the hope of ensuring AI tools \u201creflect the principles of evidence-based medicine and provide physicians with information they can understand, evaluate and trust,\u201d according to the release. Another AMA policy calls for regulations to guarantee that health coverage decisions \u2014 which are increasingly based on AI, according to the release \u2014 are reviewed by physicians in appropriate fields with a foundation of evidence-based, up-to-date medical information. The policy additionally called for safeguards requiring AI technologies be integrated into a physician-led process and increased transparency when AI is involved in prior authorization decisions, including the disclosure of any guidelines, data sources or clinical logic used in adverse decisions. In this vein, the AMA is advocating for regular audits of clinical review tools driven by AI to help strengthen accountability. That also includes audits triggered by \u201csignificant changes to\u201d training data, clinical guidelines or AI models themselves, \u201cas well as comprehensive annual reviews to ensure continued alignment with standards of care,\u201d according to the release. \u201cWhen health plans use AI-driven tools to deny or delay care without explaining how those decisions were reached, physicians and patients are left in the dark,\u201d Whyte said in the release. \u201cAI should never function as an unaccountable black box. Health plans must be transparent about how these tools work, what evidence and data sources they rely on, and whether a qualified physician reviewed the decision.\u201d Perspective Back to Top The idea that AI should \u201csupport, not replace\u201d physician judgment is not controversial. It\u2019s obvious. The real issue is that, across health systems today, we are already drifting in the opposite direction \u2014 quietly, incrementally and often without enough oversight. AI tools are being embedded into workflows, influencing decisions and shaping clinical behavior faster than governance models can keep up. How many physicians are actually aware that they are using AI? The greatest risk is not that AI will replace physicians overnight. It\u2019s that it will subtly erode clinical judgment through automation bias, opaque recommendations and overreliance on systems that clinicians neither fully understand nor control. In that sense, the danger is not disruption, it\u2019s complacency. What the AMA policy stops short of saying explicitly is this: physician oversight alone is not enough. Oversight without infrastructure, governance and accountability is performative. Health systems need enterprise-level AI operating models \u2014 clear standards for validation, monitoring and lifecycle management \u2014 because fragmented, point-solution AI adoption is already creating measurable clinical and operational risk. Deepti Pandita, MD, FACP, FAMIA University of California Irvine Health &#13; Disclosures: Pandita reports no relevant financial disclosures.&#13; Sources\/Disclosures Source: &#13; Press Release&#13; &#13; Disclosures: &#13; Whyte reports being CEO of the AMA.&#13; Ask a clinical question and tap into Healio AI&#8217;s knowledge base. &#13; PubMed, enrolling\/recruiting trials, guidelines &#13; Clinical Guidance, Healio CME, FDA news &#13; Healio&#8217;s exclusive daily news coverage of clinical data &#13; Learn more &#13; &#13; &#13; Add topic to email alerts&#13; &#13; &#13; Receive an email when new articles are posted on &#13; Please provide your email address to receive an email when new articles are posted on . &#8220;&#13; data-action=&#8221;subscribe&#8221;&gt;&#13; Subscribe&#13; We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com. 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