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Shifting Health Policy Landscape Brings Opportunities, Responsibility to Advocate for Rheumatology

Joan M. Von Feldt, MD, MSEd, FACR, FACP  |  Issue: October 2016  |  October 10, 2016

We continue to leave no stone unturned in opposing this demonstration project as proposed, and will seek Congressional action if the demonstration project moves forward without significant alteration. It’s not too late for you to express your concerns. Go to the ACR’s Legislative Action Center to send a message to your representatives.

Increasing Funding for Research

The College continues to fight for adequate funding to discover the next breakthrough treatments. Focus initiatives include creating a $20 million dedicated arthritis research program at the DOD, supporting $34.5 billion for the NIH and $13 million for the CDC Arthritis Program in FY 2017 and mandatory NIH funding included in 21st Century Cures legislation.

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Advancing Rheumatology! on Capitol Hill

Two fly-ins to Washington, D.C., were held this year to educate policy makers on issues of concern to the rheumatology community. The Advocacy Leadership Conference was held May 11–12. The ACR Board of Directors, committee chairs and members of the Government Affairs Committee, RheumPAC Committee and Affiliate Society Council met with legislators and staff. The Advocates for Arthritis conference took place Sept. 12–13, and more than 100 rheumatologists, health professionals and patients went to the Hill. Want to attend this conference next year? Watch for the application in summer 2017.

Rheumatology Issues in the States

The advocacy focus at the state level continues to involve biosimilar substitution, step therapy and prior authorization. Several states have passed requirements to notify the prescriber within five days of substitution of a biosimilar. Step therapy initiatives allowing patients to bypass already failed therapies and providers to shorten the length of a step made progress as well. ACR policy supports care that is patient centric and that allows providers to determine the best course of care.

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Prior authorization (PA) legislation has been successful in Ohio this year. SB 129 requires insurers to have a Web-based system to receive PA requests, have shorter timeframes for prior authorization decisions in urgent situations, allow request of retrospective reviews and prohibit retroactive denials regarding coverage or medical necessity as long as the procedure was performed within 60 days of an authorization. Our policy seeks simplification and reduction of administrative burdens of PAs, and the ACR is involved in a PA working group of the AMA to develop additional solutions.

7 Things for Your To-Do List

If you are concerned about these issues, please join in efforts to educate and advocate. It’s easier than you think. Here are seven ways to join your rheumatology colleagues in advocacy.

  1. If you’re a U.S.-based member of the ACR or ARHP, invest in advocacy with RheumPAC! RheumPAC is the only advocacy committee that directly represents the interests of rheumatology professionals, working to support and elect pro-rheumatology candidates. RheumPAC is nonpartisan and makes contributions based on policy positions. These dollars give your concerns a seat at the table. Invest at RheumPAC.
  2. Attend local events for candidates and lawmakers you support. The RheumPAC Committee may provide a contribution to present from RheumPAC for candidates in election campaigns in the U.S. House or Senate. Make a recommendation for RheumPAC support at RheumPAC.
  3. Send messages to Congress. Go to the rheumatology Legislative Action Center. There, you can read more about all of these issues and find pre-written email messages. We also offer tools to easily find your members of Congress and quickly send them your thoughts on these important issues. You can contact our Government Affairs department at [email protected] to assist you in your efforts.
  4. Develop a personal relationship with your representatives in Congress and their staff. Visit them while you’re in Washington, D.C., or at their home offices in your district. Invite your Congressional representatives or a member of their staff to spend a day in your office. Allowing members of Congress to witness firsthand a constituent’s rheumatology office gives them perspective on the severity of patients’ conditions, the complexity of care, the reimbursement needs of physicians and the necessity for research.
  5. Take a leadership role in your local or state rheumatology society. If there’s not a society for your area, start one. Find your society and other resources.
  6. Join the American Medical Association to keep rheumatology at the table to influence AMA advocacy and positions, and to guide reimbursement and coding policy. Go to https://commerce.ama-assn.org/membership to join or renew your membership. This is a critical step. We also need you to vote for the ACR as your specialty organization, which counts your membership toward rheumatology’s seats.
  7. Attend the MACRA, Legislative Update and Advocacy Training sessions at the Annual Meeting next month in Washington, D.C. Please put these meetings in your planner:
    • Holy MACRA! How to Survive and Thrive in the New Era of MACRA, MIPS and APMs; Sunday, Nov. 13, 8:30–10 a.m.
    • Legislative Update with Policy Makers; Tuesday, Nov. 15, 7:30–8:30 a.m.
    • Advocacy Training and Workshop; Tuesday, Nov. 15, 10:30–11:30 a.m.

I look forward to seeing you at the ACR Discovery Center in the Exhibit Hall at the Annual Meeting. I want to thank you for devoting some of your time to advocacy for the sake of our patients. I am proud to join you in Advancing Rheumatology!

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Filed under:Legislation & AdvocacyPresident's Perspective Tagged with:AdvocacyAmerican College of Rheumatology (ACR)CongressHealthcarelegislatorsMedicarepatient carepolicyRheumatic Diseaserheumatology

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