The ACR is committed to advocating for appropriate coverage and payment policies. The volunteer members of the Insurance Subcommittee (ISC) lead this effort by representing the ACR and its membership to the insurance industry. The ISC engages payers to ensure their policies are clinically appropriate and promote patient access to high-quality care and treatment. The ISC also serves as a valuable resource to payers by performing reviews of various draft drug and treatment policies.
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Some of the major issues the ISC tackled in 2016 include Medicare’s downcoding of biologic drugs, site of service policies, formulary tier changes and inclusion of off-label information in the Medicare-approved compendia. The ISC was also successful in working with payers to ensure continued access to infusibles, coverage for ultrasound for RhMSUS-certified physicians, fixing an error in coverage for DXA and preventing a coverage change for steroid injections of the knee and shoulder.
Visit Insurance Advocacy to learn more about what the ISC is working on. The ISC is ready and willing to assist ACR members with individualized support on policy and reimbursement issues. If you need assistance, complete the online health plan complaint form or contact [email protected].
2016–2017 Insurance Subcommittee Members
Sean Fahey, MD—Chair
Kamala Nola, PharmD, MS—ARHP Representative
Anne Eberhard, MD, MSc
Daniel El-Bogdadi, MD
Howard Kenney, MD
Barry Myones, MD
Yvonne Sherrer, MD
Richard Stern, MD
Catherine Sullivan, MD
If you are interested in becoming a member of the Insurance Subcommittee, or for more information, contact Meredith Strozier at [email protected].