Aetna recently notified practices about the launch of its Combined Benefit Management Drug List, which will result in romosozumab-aqqg (Evenity) and infliximab (Remicade) moving to pharmacy-only coverage on July 1. The ACR is working to oppose this change.
Aetna Expands Evaluation & Management Downcoding Program
Aetna recently expanded its Claim and Code Review Program, which results in the downcoding of certain level 4 and 5 evaluation and management claims. Practices are advised to monitor remittance documents for appropriate reimbursement.
One Rheumatologist’s Sabbatical for Contemplative Leisure
The year before my hike, I was extremely busy with various ACR workforce issues; meetings; presentations, locally, regionally and nationally; juggling medical missions and more. However, I had blocked time in my calendar over one year in advance to hike the Camino de Santiago in Spain with a long-time U.S. Army buddy. I met Pat…
President’s Corner: The ACR & Pediatric Rheumatology
My first exposure to pediatric rheumatology came during my adult rheumatology fellowship, when pediatric rotations were part of our curriculum. This experience brought home for me the many differences between childhood and adult rheumatic diseases and the important role pediatric rheumatologists play in patient outcomes. This role has long been appreciated by the ACR/ARP, where…
Rheuminations: The Metaphors, Mythologies & Rituals of Medicine
“Doctor, I hate to tell you this but that shelf is definitely not made of wood,” my patient gently chided me as I knocked on a plastic piece of shelving. “I know … but you get the point,” I replied with a small laugh. It’s become a habit of mine over the past few years…
Psychosocial Factors & Pain in Hand Osteoarthritis
Attention to factors beyond the standard nociceptive model of painin patients with hand OA, including psychosocial considerations &other comorbidities, may impact a patient’s pain perception &pain course.
Case Report: Lupus Nephritis, or a Mimic?
Syphilis, an ancient disease caused by the spirochete Treponema pallidum, has been historically referred to as the great mimicker given its heterogenous presentation. Both systemic lupus erythematosus (SLE) and syphilis can have multi-systemic involvement. Both parvovirus B19 and syphilis have been reported to cause histologic features similar to those seen in lupus nephritis. We present…
Complications: Renal Arteriosclerosis in Patients with Lupus Nephritis
Renal arteriosclerosis is common in patients with lupus nephritis and occurs two decades earlier than it does in people without the condition, say investigators in a study that examined the prevalence of renal arteriosclerosis in patients with lupus nephritis compared with healthy controls.1 The finding suggests that renal arteriosclerosis could be used as a biomarker…
Autoantibodies Illuminate Lupus Nephritis
In this study, Fava et al. investigated longitudinal autoantibody profiles in a racially diverse cohort of patients with lupus nephritis to define noninvasive serological biomarkers of histologic class and one-year treatment response to standard of care. In addition, the researchers determined how these biomarkers changed over time to provide further insights into treatment response and…
Research Reviews: AURORA 2, & Urinary Biomarkers
AURORA 2 Voclosporin, a novel calcineurin inhibitor (CNI), is associated with a favorable metabolic profile with regard to lipids and glucose, and a predictable pharmacokinetic profile, resulting in no need for the therapeutic drug monitoring required of other CNIs. AURORA 2, a double-blind, phase 3 study, evaluated the longterm safety, tolerability and efficacy of voclosporin…
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