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The ACR Helps Members Meet Insurance Challenges

Audrey B. Uknis, MD  |  Issue: January 2013  |  January 1, 2013

  • Jeffrey Lawson, MD, reported that the South Carolina Rheumatism Society created an insurance committee that works throughout the state. Several members work on insurance issues that happen within the state and meet with insurance companies.
  • Jeff Peterson, MD, informed ASC that the Washington State Rheumatology Association succeeded in preventing a pharmacy benefits manager (PBM) from becoming a sole-source supplier for all infusion services. The association, through a show of solidarity, postponed implementation (which may be an indefinite postponement) by notifying members throughout the state and meeting with the PBM.
  • Meera Oza, MD, from the Florida Society of Rheumatology (FSR), mentioned that the FSR holds annual meetings and brings in great speakers, engaging all rheumatologists in the state. The FSR meeting even includes an exhibit hall. At another meeting, Yvonne Sherrer, MD, member of the ACR board of directors, mentioned that the FSR has hired a state lobbyist to work on legislative issues at the state level.
  • Max Hamburger, MD, invited Kathleen Arnt­sen to a meeting to share her success with Tier IV legislation in New York. Other states are trying to replicate this success. The ACR worked with Rep. McKinley (WV) to introduce similar legislation at the federal level.
  • Gary Feldman, MD, discussed the success of the California Rheumatology Alliance with prior authorization legislation. This reform requires the state to use a standard prior authorization form, limited to less than two pages. The ACR continues to encourage insurance companies to use a standard prior authorization form and works with government committees on this topic.

These are just a few brief examples of the knowledge and experience that is shared through the ASC meetings. Member societies have been very active and are able to share meaningful successes.

In addition to the sharing of best practices, the ACR provides special products and programs to facilitate the work of the societies. ASC members are able to request a limited number of blast e-mails for the members in their state each year. State list serves are also available on an opt-in basis, providing the opportunity for ASC members to quickly and easily communicate with their members. Presentations are available to ASC members at no charge, including an overview of the College from a board member and presentations on government affairs, coding, auditing, and insurance issues. Meeting space at the annual meeting is made available at no cost for state societies to bring attendees together. I attended our own Pennsylvania society meeting in Washington, D.C., a few weeks ago, where I heard the results of a statewide survey on prescribing habits in the treatment of rheumatoid arthritis. I would encourage state societies to use these benefits in developing robust and meaningful programming for their members

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Filed under:President's Perspective Tagged with:AC&Rrheumatology

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