Greetings, advocates! This month’s Washington update covers how Congress’s tax proposals affect rheumatology, the ACR’s plan to fight Medicare’s adjustments to Part B drug costs in MIPS, the good news of Medicare’s new individualized biosimilar reimbursement, advances in the rheumatology-specific Alternative Payment Model and developments in Congress’s awareness about the perilous pharmacy benefit manager system….
Bisphosphonate Drug Holiday & Hip Fracture Risk
New research found women on bisphosphonate therapy who take a drug holiday experience a higher rate of hip fracture…
Trump Administration Proposes Medicare Rules Aimed at Opioids, Drug Costs
(Reuters)—The Trump administration on Thursday proposed changes to Medicare drug plans including limits on opioid prescriptions and rules aimed at reducing drug costs for seniors, such as requiring health insurers to pass on discounts to consumers. To help combat overprescription and abuse of addictive painkillers, the U.S. Centers for Medicare and Medicaid Services (CMS) said…
Biosimilars Great Debate: To Switch or Not?
SAN DIEGO—Should patients with rheumatic diseases switch from a biologic to its biosimilar? At the 2017 ACR/ARHP Annual Meeting’s Great Debate, held Nov. 5, two rheumatologists argued whether to switch or stay put based on safety, efficacy and potential cost savings. First to the podium to make the case for switching, Jonathan Kay, MD, tweaked…
How Non-Physician Providers Can Help Your Practice
New data shows that both private and public rheumatology practices benefit financially by hiring non-physician providers (NPPs). But when should practices hire NPPs?
Lower Medicaid Fees Linked to Scarcer Primary Care Appointments
(Reuters Health)—When the fees paid to healthcare providers by Medicaid go up, appointments with primary care doctors suddenly become more available to Medicaid beneficiaries – and the opposite happens when fees go down, according to a recent U.S. study. Researchers found that, overall, every $10 change up or down in the Medicaid fees paid to…
Nearly 1.5 Million People Signed Up for Obamacare Plans So Far
WASHINGTON (Reuters)—More than 800,000 people signed up for Obamacare individual health insurance plans in the second week of open enrollment, U.S. government health officials said on Wednesday, bringing the total number of sign-ups to nearly 1.5 million so far. There is particular scrutiny of how Affordable Care Act programs are faring after a year in…
Senate Finance Chairman Revises Tax Plan to End Obamacare Mandate
WASHINGTON (Reuters)—The head of the U.S. Senate Finance Committee proposed major changes to a Republican tax reform plan, adding a repeal of Obamacare’s health insurance mandate and making corporate tax cuts permanent while ending individual cuts in 2025. In a statement late on Tuesday, committee chairman Orrin Hatch said the proposed changes would also slightly…
What You Need to Know about the New Medicare Card Project
Beginning in April 2018, Medicare patients will receive newly designed Medicare identification cards that replace their Social Security numbers (SSNs) with unique, randomly assigned, alphanumeric identification numbers. The Centers for Medicare & Medicaid Services (CMS) is making the change to protect patients 65 and older from exposing their SSNs in efforts to “help prevent fraud,…
Golimumab Receives 2 More FDA Approvals
The FDA has expanded the indications for golimumab, an anti-TNF-alpha monoclonal antibody, to include the treatment of active psoriatic arthritis and ankylosing spondylitis…
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