The ACR Government Affairs Committee met in mid-December to discuss federal and state issues that the ACR will be focused on in the coming year. The 2016 top advocacy priorities are as follows:
- Ensure the Medicare Access and CHIP Reauthorization Act (MACRA) is appropriately implemented, with protection for rheumatologists. Many of the details of MACRA have been left to the Centers for Medicare & Medicaid Services (CMS), and the ACR focus areas may include influencing the details of the Merit-Based Incentive Payment System (MIPS), Alternative Payment Models (APMs), Quality Clinical Data Registries (QCDRs), financial support for practices and other components; and
- Stop Medicare contractors’ downcoding of biologic infusions, and ensure appropriate reimbursement for complex infusion administration.
- Address specialty tiers/co-insurance; end excessive patient cost sharing in commercial plans;
- Pursue new strategies complementing Patients’ Access to Treatments Act to potentially include Senate hearings, GAO investigation of pharmacy benefit manager practices and transparency issues; and
- Secure line-item funding for a dedicated $20 million arthritis research program at the U.S. Department of Defense.
- Address step therapy/step edits impeding patient access to appropriate treatment;
- Streamline prior authorization processes and forms; and
- Address specialty tiers/co-insurance; end excessive patient cost sharing.
These are only a few of the many issues affecting rheumatologists, practices and patients. They represent the focus areas on which the ACR will lead or play a leading role in concert with partnering physician and patient organizations.
Get involved in these and other advocacy issues in 2016. Visit the ACR’s new Legislative Action Center.