The Insurance Subcommittee is working on behalf of ACR members to address underwater formulary requirements for biosimilars, mandated switches to biosimilars, evaluation and management downcoding and more.
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Hit the Ground Running with New Insurance Subcommittee Chair Michael Feely, MD
Dr. Feely discusses his previous work with the College, his current work as a practicing rheumatologist and how he will lead continued advances on the insurance front.
Updates from the ACR Insurance Subcommittee
The ACR Insurance Subcommittee (ISC) of the Committee on Rheumatologic Care has been hard at work, advocating to payers on behalf of the ACR and its members. Following is an update on some of the work this group has been doing to help address concerns about reimbursement and administrative burden, while ensuring continued access to…
Insurance Denial Woes? The ACR Can Help with Appeal Letter Templates
Don’t reinvent the wheel. The ACR Committee on Rheumatologic Care offers members an updated slate of template letters to help appeal insurance denials for common off-label rheumatology treatments.
Updates from the ACR Insurance Subcommittee
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.
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.
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