The Insurance Subcommittee is working to address coverage and reimbursement challenges facing rheumatology practices, including issues related to biosimilar use, in-office treatments and the new G2211 code.
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Updates from the ACR Insurance Subcommittee Chair
The Insurance Subcommittee is working to address coverage and reimbursement challenges facing rheumatology practices. Recent activities include efforts to avoid increased administrative burden associated with specialty medications, support payer coverage of musculoskeletal ultrasounds and protect patient access to biologics.
ACR Insurance Subcommittee Tackles Known Issues
During a busy start to 2023, the ISC has been advocating with payers to address multiple coverage and reimbursement challenges facing rheumatology practices, including Cigna’s modifier 25 requirements, hydroxychloroquine access and coverage for apremilast combination therapy.
A Unique Partnership Gives the ACR a Voice in Insurance Legislation Development
A recent meeting of the National Council of Insurance Legislators (NCOIL) featured discussions of many topics important to ACR members, including pharmacy benefit manager legislation, biomarker testing and transparency in the healthcare market.
September Updates from the ACR Insurance Subcommittee
In recent months, the ISC has engaged with payers to reduce administrative burden on practices and continues to advocate to the CMS for the use of complex administration codes for biologics.
Update from the ACR Insurance Subcommittee
The ISC has worked with CVS Caremark to revisit changes to its prior authorization forms that would have increased the administrative burden on practices, and patients with Blue Cross Blue Shield of South Carolina may not have to worry about switching to a self-administered biologic.
ACR Insurance Subcommittee Chair Encourages Member Engagement
Rheumatology practices have a voice in payer advocacy through the Insurance Subcommittee of the ACR’s Committee on Rheumatologic Care.
Executive Order Targets Prescription Drugs & Health Insurance to Promote Competition
On July 9, U.S. President Joe Biden issued an Executive Order designed to promote competition in the U.S. economy. The order includes 72 initiatives related to various aspects of the economy, including prescription drugs and health insurance.1 For prescription drugs, Americans pay more than 2.5 times as much for the same prescription drugs as patients…
State-of-the-Art Clinical Symposium Premeeting Courses Feature Billing, Coding & Insurance Opportunities
Courses before the 2021 State-of-the-Art Clinical Symposium will focus heavily on what’s new in practice, including mastering evaluation and management changes and access to treatments in rheumatology. Early bird registration ends March 31.
Experts Discuss Current Insurance Issues Challenging Rheumatology
ATLANTA—From step therapy requirements to infusion center locations to evaluation and management coding, insurance issues bring frequent headaches to clinicians and patients. Experts discussed some of the most recent concerns in a session at the 2019 ACR/ARP Annual Meeting. Chris Phillips, MD, chair of the ACR’s Insurance Subcommittee (ISC), and Gary Bryant, MD, delegate to…
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