The Stark law prohibits a physician from referrals to entities in which they have a financial relationship, unless an exception applies (common exceptions include in-office ancillary services so that physicians can furnish designated health services to their practice’s patients). In-office dispensing of medication has been associated with improved patient access and adherence. Although the provisions of this resolution will not prevent insurers, PBMs and others from requiring use of selected delivery mechanisms (such as white bagging, brown bagging, etc.) to drive down costs by restricting patient choice, clarifying this exception to the Stark law would ensure physician practices that use an in-office pharmacy would be able to choose the best delivery method for their individual patients.
Shaping Policies on Biosimilars
At the meeting, the ACR and partnering societies were also able to raise concerns about and defeat a proposal, Resolution 102, that would have upended the current buy-and-bill system for the delivery of Part B medications by creating a fixed add-on payment for biosimilars and biologics, and potentially affect the biosimilar marketplace adversely. Instead of these changes to Part B, the ACR’s delegation suggested looking at changes to Part D, the area most in need of reform to lower costs and increase patient access.
The ACR’s delegation was also closely involved in deliberations and policy modifications during debates on Resolution 245 on the biosimilar interchangeability pathway policy. The ACR was able to represent and express the experiences of the rheumatology community with biosimilars, a prime topic as more biosimilars—including some interchangeable biosimilars—come onto the market. As a result of this work alongside multiple partners, the resolution was not passed and instead was referred for study by the AMA’s Council on Science and Public Health (CSAPH). The ACR will actively work with the Council to ensure the experiences and needs of rheumatology practices and patients are reflected in the resulting study and recommendations.
Resolutions are introduced and considered by the ACR based on its positions and policies and the work of ACR committees and the Board of Directors. The ACR’s delegation to the AMA House of Delegates consists of Gary Bryant, MD (delegate and delegation chair), Eileen Moynihan, MD (delegate), Cristina Arriens, MD (alternate delegate), Colin Edgerton, MD (alternate delegate), Luke Barre, MD (Young Physician Section representative), Christina Downey, MD (Young Physician Section representative) and Rami Diab, MD (Resident and Fellows Section representative).
The ACR asks rheumatologists to join or renew membership in the AMA so this work may continue. Rheumatology’s voice at the House of Delegates meeting is determined based on the number of ACR members who are also members of the AMA, so every single person who is a member of both the ACR and the AMA adds to the strength of this effort. Visit the AMA’s membership site to join or renew your AMA membership and receive valuable membership benefits along with helping to advance rheumatology.
