The Rheumatologist
COVID-19 News
  • 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
      • Systemic Lupus Erythematosus Resource Center
      • Rheumatoid Arthritis Resource Center
      • Gout Resource Center
      • 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 Continues to Advocate Against Payer Mandates on Specialty Pharmacy Acquisition of In-Office Treatments

ACR Continues to Advocate Against Payer Mandates on Specialty Pharmacy Acquisition of In-Office Treatments

June 5, 2020 • By From the College

  • Tweet
  • Email
Print-Friendly Version / Save PDF

The ACR is very concerned about the growing number of health plans requiring specialty pharmacy acquisition of in-office treatments. These requirements limit practices’ ability to continue providing these treatments and harm patient access to critical therapies.

You Might Also Like
  • ACR Advocates Against Payer Mandates on Specialty Pharmacy Acquisition of In-Office Treatments
  • Coverage & Reimbursement Challenges: Updates from the ACR Insurance Subcommittee Chair
  • Advocate from Your Office the Week of March 14
Also By This Author
  • Coding Corner Question: Evaluation & Management Documentation Quiz

Despite advocacy from the ACR and other organizations, Blue Cross Blue Shield of Tennessee has indicated that it will move forward with implementation of its specialty pharmacy acquisition mandate on July 1, 2020. The ACR is concerned that the negative impact of this decision on practices and patients will be exacerbated by the timing of the change. During the current COVID-19 public health crisis, health plans are urged to avoid implementing any policy change that would increase administrative burden or further disrupt patient care.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

Blue Cross Blue Shield of Tennessee and other select health plans have presented specialty pharmacy mandates to employers as a way to control spending on specialty drugs covered under their employer-sponsored health plans. The ACR is reaching out to these companies to provide information on the impact of these requirements on their employees and offers a template letter for practices interested in reaching out to their patients’ employers directly. In partnership with the Arthritis Foundation, the ACR has also created a fact sheet to help educate patients and employers about the harmful consequences of these specialty pharmacy mandates.

The ACR will continue to advocate against policies that mandate specialty pharmacy acquisition of in-office treatments. In response to the unprecedented challenges faced as a result of COVID-19, the ACR will also continue to urge payers to delay any policy that would increase administrative burden or disrupt patient care so that members can remain focused on patient care at this critical time.

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

For questions or more information, contact [email protected].

Filed Under: Legislation & Advocacy Tagged With: Blue Cross Blue Shield, In-office treatment, specialty drug acquisition

You Might Also Like:
  • ACR Advocates Against Payer Mandates on Specialty Pharmacy Acquisition of In-Office Treatments
  • Coverage & Reimbursement Challenges: Updates from the ACR Insurance Subcommittee Chair
  • Advocate from Your Office the Week of March 14
  • ACR Insurance Subcommittee Responds to Payer Policies

American College of Rheumatology

Visit the official website for the American College of Rheumatology.

Visit the ACR »

Rheumatology Research Foundation

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

Learn more »

Meeting Abstracts

Browse and search abstracts from the ACR Convergence and ACR/ARP Annual Meetings going back to 2012.

Visit the Abstracts site »

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

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

Copyright © 2006–2022 American College of Rheumatology. All rights reserved.

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