Video: Every Case Tells a Story| Webinar: ACR/CHEST ILD Guidelines in Practice

An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

  • Conditions
    • Axial Spondyloarthritis
    • Gout and Crystalline Arthritis
    • Myositis
    • Osteoarthritis and Bone Disorders
    • Pain Syndromes
    • Pediatric Conditions
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Sjögren’s Disease
    • Systemic Lupus Erythematosus
    • Systemic Sclerosis
    • Vasculitis
    • Other Rheumatic Conditions
  • FocusRheum
    • ANCA-Associated Vasculitis
    • Axial Spondyloarthritis
    • Gout
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Systemic Lupus Erythematosus
  • Guidance
    • Clinical Criteria/Guidelines
    • Ethics
    • Legal Updates
    • Legislation & Advocacy
    • Meeting Reports
      • ACR Convergence
      • Other ACR meetings
      • EULAR/Other
    • Research Rheum
  • Drug Updates
    • Analgesics
    • Biologics/DMARDs
  • Practice Support
    • Billing/Coding
    • EMRs
    • Facility
    • Insurance
    • QA/QI
    • Technology
    • Workforce
  • Opinion
    • Patient Perspective
    • Profiles
    • Rheuminations
      • Video
    • Speak Out Rheum
  • Career
    • ACR ExamRheum
    • Awards
    • Career Development
  • ACR
    • ACR Home
    • ACR Convergence
    • ACR Guidelines
    • Journals
      • ACR Open Rheumatology
      • Arthritis & Rheumatology
      • Arthritis Care & Research
    • From the College
    • Events/CME
    • President’s Perspective
  • Search

The ACR Responds to CVS Caremark Prior Authorization Changes

From the College  |  Issue: September 2021  |  August 20, 2021

On July 1, CVS Caremark updated its prior authorization forms for many biologic drugs. These changes have resulted in an increase to the already overwhelming paperwork burden rheumatology practices face.

The ACR sent a letter to CVS Caremark detailing specific concerns about the prior authorization changes and their impact on rheumatology practices and patients’ timely access to treatment and was able to follow up with a direct phone meeting. Chief among the ACR’s concerns are new criteria regarding the evaluation of treatment efficacy for continuation of therapy requests. CVS Caremark leaders have acknowledged these concerns and committed to revising the forms for a more streamlined and user-friendly process.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

ACR will continue to monitor this issue to ensure it is appropriately resolved. We encourage members to contact [email protected] with any questions or concerns.

Share: 

Filed under:Billing/CodingLegislation & Advocacy Tagged with:insurance advocacyprior authorization

Related Articles
    Georgia Bonney

    Prior Authorization Woes: Barriers to & Delays in Care, Administrative Hassles & Potential Solutions

    August 6, 2021

    As insurers phase out pandemic-related flexibilities, many are raising new obstacles to try to limit their financial exposure.

    CVS Issues Revised Prior Authorization Forms

    May 5, 2022

    In response to ACR and provider concerns about administrative burden, CVS Caremark has issued a streamlined version of its prior authorization forms for many biologic drugs.

    CVS Caremark to Revise Prior Authorization Forms in January 2022

    December 15, 2021

    The reassurance comes after ACR leadership sent a letter detailing how its prior authorization forms increased paperwork burden for many biologic drugs and hurt patients’ timely access to treatment.

    CVS Health to Acquire Aetna for $69 billion

    December 4, 2017

    (Reuters)—U.S. drugstore chain operator CVS Health Corp said on Sunday it had agreed to acquire U.S. health insurer Aetna Inc. for $69 billion, seeking to tackle soaring healthcare spending through lower-cost medical services in pharmacies. This year’s largest corporate acquisition will combine one of the nation’s largest pharmacy benefits managers (PBMs) and pharmacy operators with…

  • About Us
  • Meet the Editors
  • Issue Archives
  • Contribute
  • Advertise
  • Contact Us
  • Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 1931-3268 (print). ISSN 1931-3209 (online).
  • DEI Statement
  • Privacy Policy
  • Terms of Use
  • Cookie Preferences