WASHINGTON, D.C.—Dozens of rheumatology leaders met with more than 100 politicos on Capitol Hill in mid-May as part of the ACR’s annual Advocacy Leadership Conference. Armed with research and advocacy training concerning a handful of important issues, rheumatologists, rheumatology interprofessional team members, government affairs specialists and others met with federal lawmakers, legislative aides and correspondents.
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Explore This IssueJuly 2019
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The two-day conference, which featured the May 16 Hill meetings, is one of two major organized events during which rheumatology leaders descend on Washington to meet with federal lawmakers. Unlike September’s Advocates for Arthritis event, this event did not include patients; instead, the leaders advocated for these issues:
Issue 1: Support for the Safe Step Act to Counter Step Therapy
This act would create a clear and transparent process for many patients to get exceptions to step therapy (or fail first), require insurers to consult patient medical histories and with providers before denying medically necessary treatments, and establish a clear and reasonable time frame for over-ride decisions.
Issue 2: Stabilization of the Rheumatology Workforce in the Long Term
The ACR is asking legislators to pass legislation that would provide loan repayment for pediatric subspecialists (including in rheumatology) and address pediatric public health disparities in children’s hospitals’ graduate medical education programs. These initiatives would help counter a trend that shows the projected demand for rheumatologists far exceeding the supply over the next dozen years.
Issue 3: Prior Authorization Reform
The ACR is asking for legislation that would improve the transparency and efficiency of the prior authorization process, helping patients access care without facing dangerous delays. Congress should require prior authorization be standardized and allow for electronic options, force insurance companies to reveal coverage restrictions levied at the point of care and eliminate prior authorization altogether for the most-approved therapies. (A House bill was introduced June 5.)
Issue 4: Improved Access to Osteoporosis Testing in Medicare
A sustainable payment for dual-energy X-ray absorptiometry (DXA) bone density scans conducted in physicians’ offices needs to be established. Medicare reimbursement for DXA scans has dropped by 70% over the past decade, and active payment rates don’t cover physicians’ costs to provide this service. (A Senate bill was introduced in January, and a House bill in May.)
Issue 5: Invest in Arthritis Research at the U.S. Department of Defense (DoD)
The ACR is asking for the appropriation of a dedicated $20 million line item in the DoD research program’s budget. That program lacks funding earmarked for arthritis research, despite listing similar dedicated budgets for other diseases—and despite arthritis being a major condition afflicting U.S. service members.