The ACR advocates on behalf of rheumatologists, rheumatology health professionals and the rheumatology community through involvement in federal and state legislation and regulatory action, participation in hearings and education of lawmakers on issues important to rheumatologists, health professionals and patients.
Through robust federal and state advocacy programs, the ACR engages lawmakers and informs them of the priority issues affecting ACR members and millions of patients. The ACR is currently advocating on behalf of the following policies:
1.Patients’ Access to Groundbreaking Treatments
The Patients’ Access to Treatments Act has been reintroduced and is now H.R. 1600. This legislation would eliminate co-insurance for medications placed on specialty tiers. By forcing patients to pay a percentage of the cost instead of a flat co-pay, monthly treatments can cost thousands of dollars out of pocket. Patients are often unable to remain on important stabilizing medications, which can lead to declining conditions, disability and more.
H.R. 1600 would allow more patients to access biologic drugs by limiting the patient cost-sharing burden that can be imposed for these treatments. It would limit cost sharing for treatments placed in a specialty drug tier (typically Tier IV or higher) to the highest cost sharing a plan requires for drugs in its most expensive non-preferred brand drug tier (typically Tier III).
2.Unfair & Overly Restrictive Insurer Practices That Limit Patient Access
All across America, patients are unable to access vital healthcare services due to overly restrictive insurer practices. Patients deserve access to care, accurate and timely information, and transparency from their health insurance plans. Physicians deserve a fair, meaningful and timely appeals process for network removal—one that considers whether removing the physician from the network results in network inadequacy.
The Flex-IT 2 Act (H.R. 3309) is an important first step to address the problem of unfair and overly restrictive insurer practices. If enacted, it would amend titles XVIII and XIX of the Social Security Act to improve the electronic health records Meaningful Use programs under the Medicare and Medicaid programs, among other purposes.
3.Investment in Medical Research
Medical research funded by the National Institutes of Health (NIH)—the largest source of funding for medical research in the world—has led to extraordinary improvements in the lives of patients living with rheumatic diseases. Yet, the NIH receives nearly 25 percent less funding than it did in 2003. Increased federal funding is crucial to advancing treatment and cures.
Arthritis research is particularly important for U.S. veterans. One in every four veterans has been diagnosed with arthritis, which is the second leading cause of discharge from the U.S. Army. Although the Department of Defense (DOD) has a dedicated research budget for more than 20 specific diseases, arthritis does not yet have a dedicated research program.