ACR Advocacy: Past Wins, Future Outlook

Greetings, advocates!

Your government is back to work after ending a brief government shutdown by passing a short-term continuing resolution (CR), which will keep the government running at current funding levels into February. At some point, it would be great for Congress to pass a budget (instead of a CR) and to enact bipartisan plans to increase biomedical research funds through the NIH. Several important issues complicated negotiations for the CR and the budget, including DACA, immigration and, possibly, ACA insurance market stabilization. The landscape is busy, and your advocacy team will continue to work hard to advance our profession’s top issues.

2017 in Review
Before I get into our 2018 outlook, here are a few wins and accomplishments the ACR advocacy team logged in 2017 through the work of dedicated volunteers and staff, like-minded coalition partners and relationships formed via RheumPAC (by the way, Happy RheumPAC New Year! Please make your 2018 investment today.):

• Reduced Medicare penalties by 50% for 2018;
• Delayed an insurance carrier policy to drop reimbursement for consultations;
• Cancelled the Medicare Part B Demonstration plan to cut reimbursement for medication administration in the office;
• Drafted an alternative payment model (APM) for rheumatoid arthritis. Colin Edgerton, MD, FACP, RhMSUS, chair of the ACR’s Committee on Rheumatologic Care, testified before Congress about the APM, asking for reduced risks and hurdles to qualify for the APM track (listen to his testimony, which starts at 2:35:08);
• Boosted NIH research funding by $2 billion;
• Pushed for transparency of pharmacy benefit managers (PBMs). As a result, the Senate held two hearings to publicize the dealings of PBMs and the need for transparency in the troubling drug rebate system (thanks specifically to the Alliance for Transparent & Affordable Prescriptions);
• Reversed the Medicare policy to reimburse for in-office biosimilars based on average of drugs in groups, which would have increased financial risks to practices. The new policy will reimburse drugs individually;
• Successfully called on the U.S. to restart premium processing for physicians applying for H-1B visas to work in underserved areas and boost our workforce;
• Successfully protected tax-exempt status for graduate student tuition waivers in the GOP tax bill to protect our pipeline for future medical researchers; and
• Thanks to rheumatologists and rheumatology professionals, sent more than 4,000 emails to Congress through the ACR’s Legislative Action Center (send one today); published more than 90 opinion pieces, letters to the editor and other stories; held more than 260 meetings in Congressional offices; and reviewed or monitored more than 600 pieces of legislation. You and your advocacy team are the best!

Looking Ahead
Looking to 2018, many opportunities and challenges pertain to the issues of the high cost of our medicines; growing administrative burdens; maintaining our patients’ access to care; and fostering our workforce, education and research funding. We hope to accomplish more relief for ourselves and our patients from high drug costs (see below), including a much-needed act of Congress to eliminate Part B drug costs from the MIPS payment adjustments. We’re also looking for new ways to reduce patients’ out-of-pocket expenses so they can obtain necessary treatments, for legislation to eliminate the arbitrary cap on physical therapy in Medicare and other key goals.