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Update on Legislation, Advocacy Efforts to Advance Rheumatology

Joseph Flood, MD  |  Issue: September 2014  |  September 1, 2014

The partisan end to this chapter of the SGR saga did not reflect the bipartisan, bicameral nature of the agreement itself. This agreement was years in the making. The ACR was asked several times to help with the language of the agreement, and several of our recommendations were incorporated. The opportunity for us to have a voice in the crafting of this legislation was a landmark in our endeavors to represent the needs of our members and their patients. Although not perfect, the bill is our best chance for repealing the SGR and replacing it with a formula recognizing the care we provide for patients. If passed, the agreement will afford us more of a say in quality metrics that will be incorporated in new payment models based on quality. We have heard from congressional leaders that the SGR will almost certainly not be taken up in the lame duck session, so we hope to help get this done in early 2015.

The ACR has played an active role to promote more clinically meaningful measures of quality care for rheumatologists, along with the development of tools to make it easy for rheumatologists to measure and report on quality measures for federal programs. The ACR’s RISE registry launched earlier this year, and it’s now certified by CMS as a qualified clinical data registry for quality reporting and meets the Meaningful Use requirement of reporting to a specialty registry. Easy reporting of performance on quality measures will help rheumatologists avoid payment penalties from the reporting programs and gives rheumatologists a better chance for payment increases in whichever new payment system is eventually implemented.

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Because Congress could not agree on how to pay for the repeal of SGR, they passed yet another SGR patch. The patch ends March 31, 2015, when 20%-plus cuts to Medicare reimbursement will happen unless Congress acts (again). Congress included provisions in the latest patch that constitute a major win for rheumatology and marks us as successful in our efforts to really make change for you.

The patch included a one-year delay of ICD-10 implementation, until Oct. 1, 2015. The ACR was on Capitol Hill and at RheumPAC fundraisers discussing problems with ICD-10 when the opportunity to include the ICD-10 delay in the latest patch presented itself. Our advocacy activities put us at the center of the process, and the ACR’s work at that key time played a major role in making the ICD-10 delay a reality. This was something you told us was necessary, and we were able to help get it done for you and the rest of the House of Medicine. Your RheumPAC contributions are partly responsible for putting us in this position. Your e-mails and calls to Congress also played a crucial role in enhancing the ACR presence in critical meetings at auspicious times.

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Filed under:Billing/CodingBiologics/DMARDsDrug UpdatesLegislation & AdvocacyPractice SupportPresident's PerspectiveProfessional TopicsQuality Assurance/ImprovementResearch Rheum Tagged with:AC&RAdvocacyAmerican College of Rheumatology (ACR)Association of Rheumatology Professionals (ARP)BillingBiologicsBiosimilarsCodingdrugICD-10LegislationMedicarePractice ManagementResearchrheumatologistSGRTechnology

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