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“CORC ensures the rheumatology voice is heard in all of the most critical venues,” says CORC Chair Colin Edgerton, MD, FACP, RhMSUS. “Communication with our ACR members, government agencies, payers and other stakeholders is robust and timely, focusing on patient access and practice success.”
CORC Takes Action
Dr. Edgerton shares several key activities that members of CORC have been engaged in this year on behalf of the rheumatology community of providers and patients:
- Engaging new voices in practice advocacy
CORC established a new standing member position for a pharmacist.
“We anticipate that Andrew Hochradel, PharmD, our CORC pharmacist member, will be invaluable in assisting with analysis and responses to the many drug-pricing initiatives coming from the current administration,” Dr. Edgerton says.
- Taking an even stronger stand on drug pricing
CORC has collaborated with the ACR’s Government Affairs Committee and Board of Directors as part of a drug-pricing workgroup to draft the “ACR Principles on Prescription Drug Prices and Access to Treatment.” These principles reinforce the ACR’s position on patient access to safe and effective treatments at the lowest possible cost, and supports evidence-based policies and shared decision-making to support this access to care.
“This document tackles the challenges of drug pricing and access barriers. It will inform ACR responses to administration drug pricing proposals, including the Competitive Acquisition Program and the International Pricing Index notification,” Dr. Edgerton says.
- Speaking directly with payers
Through CORC’s Insurance Subcommittee (ISC), chaired by Christopher Phillips, MD, CORC members continue to communicate with members and payers on numerous issues, including site-of-service restrictions on infused biologics and modifier 25 payment reduction policies.
“CORC was cautiously optimistic to see UnitedHealthcare hold off on formally announcing elimination of consultation codes and reducing reimbursement for E/M services by 25% when billed with a modifier 25,” Dr. Edgerton notes.
- Formalizing positions on key practice issues
In 2018, CORC established seven new position statements that impact access and coverage, treatment, and the role of rheumatology. These ACR position statements serve as official statements that reflect the position of the College. Position statements introduced by CORC this year include:
- Beers List—Outlines the ACR’s opposition to the Beers criteria, which do not account for individual diagnoses, signs, symptoms or disease severity, or for pharmaceutical formulary decisions, punitive measures or quality ratings for individual providers.
- Biosimilars—Reinforces the idea that decisions regarding the approval and use of biosimilars be driven by evidence and take into account such factors as stronger analytical evaluation, clinical data and post-market surveillance.
- Medicare Recovery Audit Contractors—Supports changes implemented by the CMS regarding the auditing structure of Medicare claims.
- Use of Diagnostic Imaging in Rheumatology Practice—Supports the ordering, performance and interpretation of imaging studies of the musculoskeletal system as an integral part of the rheumatology practice.
- Musculoskeletal Ultrasound—Supports the use of, training for and appropriate reimbursement for this imaging technique in rheumatology care.
- Pharmacovigilance—Supports robust pharmacovigilance to ensure the safety of medications used in rheumatology through federal reporting mechanisms, more thorough reporting of adverse events and improved access to pharmacovigilance systems.
- Copay Accumulator—Addresses the new insurance practice of not allowing copay assistance to count toward a patient’s deductible, thereby increasing out-of-pocket costs for patients while reducing access to therapy. “CORC was pleased to see this position statement approved by the Board of Directors this October at the ACR/AHRP Annual Meeting,” Dr. Edgerton noted.
Want to Know More?
Dr. Edgerton suggests the best way to keep up with CORC activities is to follow the ACR’s Advocacy News on the ACR website.