ACR Urges Commercial Payers to Provide Relief from Prior Authorizations, Practice Disruptions

As a result of the global pandemic, rheumatology practices are facing extraordinary clinical and economic challenges. Among other advocacy initiatives to ensure patients with rheumatic disease can continue to receive high-quality rheumatology care, the ACR is urging insurance companies to expand access to telehealth services and provide relief from administrative burdens and practice disruptions, including those from prior authorization. Providing this relief will allow rheumatology providers to remain focused on patient care at this critical time.

The Insurance Subcommittee of the ACR Committee on Rheumatologic Care recently sent a letter to payers urging them to follow the leadership of the Centers for Medicare & Medicaid Services and UnitedHealthcare by expanding access to telehealth services and providing coverage irrespective of patient or provider location. ACR also requested that payers delay implementation of any policies that would increase administrative burden or disrupt patient care. This includes any changes to formularies or utilization management criteria and any non-medical switching of therapies. To further reduce the burden on practices and ensure timely access to care, ACR also asked that payers temporarily remove prior authorization requirements.

In response to this letter, Regence BlueShield highlighted its recent decision to extend previously approved prior authorizations by six months. ACR applauds this change and will continue to advocate for other payers to take similar action.

For questions or additional information on ACR’s commercial payer advocacy efforts, contact practice@rheumatology.org.