Additionally, the ACR received strong supportive testimony for its prior authorization resolution that would explicitly lay out in AMA policy support for exceptions to prior authorization—including, for example, if evidence-based guidelines from a national specialty society are being followed, or when the order or prescription is routinely approved. The resolution resulted in reaffirmation of AMA policy on prior authorization, which currently directs readers to 21 Prior Authorization and Utilization Management Reform Principles. The ACR was an original member of the coalition that developed the principles and contributed to ideas in the document. Reaffirmation of prior authorization policy means that the policies will remain viable, and robust AMA work on prior authorization reform will continue.
The ACR’s delegation also supported several resolutions including measures addressing pharmacy benefit manager transparency issues, ways to reduce physician hassle and burdens in quality reporting programs, and repeal or modification of the Sunshine Act, as it is currently implemented, to decrease burden and support efforts at administrative simplification for physicians. Additionally, the ACR delegation worked with partnering specialties to address an AMA-authored board of trustees report on “Handling of De-identified Patient Information.” The draft report suggested reexamining and possibly limiting the use of de-identified, aggregated patient data, which could threaten viability of clinical data registries, such as the ACR’s RISE registry, for purposes of quality and practice improvement initiatives. Working with partnering societies, our coalition was able to have the report withdrawn and sent back to the AMA Board of Trustees for reconsideration.
A Note of Thanks
I would like to thank our other members of the ACR’s delegation to the AMA HOD: Eileen Moynihan, MD, Colin Edgerton, MD, and Cristina Arriens, MD. Action on behalf of ACR/ARP membership is based on policies and guidance developed by ACR committee volunteers and approved by the Board of Directors.
Additionally, the ACR thanks its Relative Value Update Committee (RUC) and Current Procedural Terminology (CPT) representatives and advisors for their dedicated service. The ACR representatives to the AMA RUC committee include Timothy Laing, MD, Eileen Moynihan, MD, Deborah Desir, MD and Fredrica Smith, MD. For the AMA CPT Editorial Committee, the ACR representatives include Dr. Laing and Joseph Huffstutter, MD. The RUC makes recommendations to the CMS regarding reimbursement for CPT codes, and having a rheumatologist as a CPT advisor gives the ACR a voice as CPT codes are being developed and modified. We are able to have a voice in these important deliberations because enough ACR members are members of the AMA.