The Rheumatologist
COVID-19 NewsACR Convergence
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Axial Spondyloarthritis Resource Center
    • Gout Resource Center
    • Psoriatic Arthritis Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
    • Interprofessional Perspective
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Gout Resource Center
      • Axial Spondyloarthritis Resource Center
      • Psoriatic Arthritis
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / ACR Advocates for Affordable Drugs & Consultation Codes

ACR Advocates for Affordable Drugs & Consultation Codes

October 31, 2017 • By Susan Bernstein

  • Tweet
  • Email
Print-Friendly Version / Save PDF

An ACR delegation will propose two new resolutions on issues affecting practicing rheumatologists and their patients at the American Medical Association Interim Meeting of the House of Delegates in Honolulu Nov. 11–14. These proposals promote transparency of pharmacy benefit manager (PBM) practices and the protection of private payer consultation codes.

You Might Also Like
  • The ACR Maintains Seat at the AMA Table, Achieves Successful Resolutions at HOD Meeting
  • UnitedHealthcare to Eliminate Consultation Codes
  • ACR Delegates Attend AMA House of Delegates Interim Meeting
Also By This Author
  • A New Approach to Fracture Prevention

Resolution 810
The ACR is introducing Resolution 810, Pharmacy Benefit Managers and Prescription Drug Affordability, with the support of the American Academy of Dermatology, the American Academy of Neurology, the American Association of Clinical Endocrinologists, the American Association of Clinical Urologists, the American College of Gastroenterology, the American Society of Clinical Oncology and the Infectious Diseases Society of America (IDSA). The resolution’s proposals “address the unreasonable and increasing cost of drugs for our patients,” says Gary L. Bryant, MD, FACP, associate professor of medicine at the University of Minnesota and the ACR delegation chair for the AMA meeting.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

The ACR has spent years visiting legislators and regulatory agencies “to address multiple factors that impact the increasing costs of prescription drugs and access to them, including exorbitant new drug prices, rising costs of generic drugs, and restrictive third-party payer policies that deny or delay appropriate care for our patients,” he says.

Resolution 810 supports the AMA’s Truth in RX campaign for more transparent drug pricing and “focuses on the increasing impact that PBMs have on prescription drug pricing, access and affordability,” says Dr. Bryant. PBMs absorb drug manufacturer rebates in exchange for inclusion on formularies, but this increases patients’ out-of-pocket costs and spurs coverage denials, the resolution states.

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

“The central issue is the manufacturer rebates to PBMs, and the perverse incentives they cause, in which the patients are the losers. In addition, this practice places a severe administrative burden on physicians to attempt to act on behalf of our patients to get them their appropriate therapy,” Dr. Bryant says.

The resolution also calls for more education of legislators to promote policies that “improve the transparency in the rebate, pricing and formulary system,” he says. Patients’ drug costs are based on list prices, not what PBMs pay after these rebates, the resolution states.

Resolution 819
The ACR also authored Resolution 819, Consultation Codes and Private Payers, which has been cosponsored by the American Academy of Allergy, Asthma and Immunology; the Infectious Diseases Society of America; and the state medical associations for Georgia, the District of Columbia and New Jersey. It calls for the AMA to discourage private insurance companies from discontinuing payments to physicians for consultation codes, and for insurance companies to engage in coding education if payments are discontinued due to coding errors or abuse.

ad goes here:advert-3
ADVERTISEMENT
SCROLL TO CONTINUE

Pages: 1 2 | Single Page

Filed Under: Legislation & Advocacy Tagged With: AMA House of Delegates (HOD), Consultation Codes and Private Payers, interim meeting, Pharmacy Benefit Managers and Prescription Drug Affordability, Resolution 225, Resolution 810, Resolution 819

You Might Also Like:
  • The ACR Maintains Seat at the AMA Table, Achieves Successful Resolutions at HOD Meeting
  • UnitedHealthcare to Eliminate Consultation Codes
  • ACR Delegates Attend AMA House of Delegates Interim Meeting
  • A Case to Reinstate Consultation Codes

Simple Tasks

Learn more about the ACR’s public awareness campaign and how you can get involved. Help increase visibility of rheumatic diseases and decrease the number of people left untreated.

Visit the Simple Tasks site »

ACR Convergence

Don’t miss rheumatology’s premier scientific meeting for anyone involved in research or the delivery of rheumatologic care or services.

Visit the ACR Convergence site »

Rheumatology Research Foundation

The Foundation is the largest private funding source for rheumatology research and training in the U.S.

Learn more »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use / Cookie Preferences

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2023 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)