After meeting with the ACR and other stakeholders, Blue Cross NC and OMI announced revisions to their Autoimmune Pathways Program to drop biologic tapering requirements and paying providers according to specific treatment decisions.
Articles by From the College
ACR Advocates with Payers Against Insufficient Reimbursement for Biosimilars
The ACR is engaging with payers regarding formulary requirements that would leave practices underwater when treating patients with rheumatic diseases.
Ask Congress to Support Complexity Add-on Code
Implementation of the G2211 add-on code for evaluation and management services is included in the CY 2024 Medicare Physician Fee Schedule, barring further delays. Ask your lawmakers to support timely implementation and patient access to complex care.
The AMA Seeks Physician Input to Inform Medicare Physician Payment
The AMA’s Physician Practice Information Survey is seeking updated data on practice costs to inform Medicare physician payment. If your practice receives a request to participate, complete this important survey to help ensure accurate payment.
Your Invitation Here: Learn How Advocacy Can Help You & Your Practice
Learn how ACR staff and volunteers support the interests of the rheumatology community in public policy efforts related to Medicare reimbursement, step therapy reform, drug pricing, supporting the medical workforce and more.
Annual RheumPAC Matching Campaign & Appreciation Event
From Oct. 15–Nov. 15, all donations to RheumPAC will be amplified by matching contributions, so it’s the best time to make your yearly investment. Donors above the silver level will be invited to a special event at ACR Convergence 2023.
The CMS Reveals First 10 Drugs for Medicare Drug Negotiation
The long-awaited list of the first 10 Part D drugs to be included in the new Medicare Price Negotiation process includes the commonly prescribed rheumatology drugs Enbrel and Stelara. Initial negotiations with the drug manufacturers will begin this fall.
ACR on the Hill: Members Ask Congress to Reduce Barriers to Care
In late September, 80 rheumatologists, rheumatology professionals and patients living with rheumatic disease convened in Washington, D.C., for the ACR’s annual Advocates for Arthritis conference, where they marshaled in support of legislation that would reduce current barriers to care for patients.
CMS Proposes Reimbursement Cuts for CY24
On July 13, the Centers for Medicare and Medicaid Services released the CY 2024 Medicare Physician Fee Schedule Notice of Proposed Rulemaking. This annual rule outlines policies related to provider reimbursement, coverage of telehealth services, review of specific codes, refinement of evaluation and management codes and updates to the Quality Payment Program.
The ACR Opposes New AI-Based Decision-Making Platform
On July 1, Blue Cross Blue Shield of North Carolina introduced a machine-learning technology platform to make decisions about patients’ care and treatment. The ACR opposes its use on grounds that it may harm patients’ access to treatment and undermine the doctor-patient relationship.
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