If enacted as is, the proposed CY 2023 Medicare Physician Fee Schedule and Quality Payment Program would make significant cuts to reimbursement for evaluation and management services, creating financial instability for providers. On a positive note, it would extend some telehealth flexibilities 151 days beyond the official end of the public health emergency.
Articles by From the College
Cigna Delays Modifier 25 Policy Change for Evaluation & Management Services
Cigna will not move forward with changes to their reimbursement policy for evaluation and management (E/M) codes submitted with modifier 25 as originally scheduled.
Applications Now Open for 2022 Advocates for Arthritis
All ACR and ARP members are invited to apply to join colleagues and patients in Washington, D.C., on Sept. 19–20 for advocacy training and meetings with legislators to advocate on priority issues that affect rheumatology providers and patients.
The ACR Responds to Reports of Treatment Denials in Wake of Dobbs v. Jackson Women’s Health Organization
The ACR is aware of the emerging concerns surrounding access to needed treatments, such as methotrexate, after the recent decision in Dobbs v. Jackson Women’s Health Organization. We are following this issue closely to determine if rheumatologists and rheumatology providers and patients are experiencing any widespread difficulty accessing methotrexate, and if any initial disruptions are…
American Medical Association House of Delegates Meets In-Person; ACR Successfully Advances New Policies
The ACR’s resolution addressing inappropriate Medicare Administrative Contractor policy processes was adopted, and two co-led resolutions on ARPA-H funding and saline shortages also passed the policy-making body.
ACR Delegation Asks AMA to Address Issues Impacting Rheumatology
After two years of special virtual sessions, the AMA House of Delegates will reconvene in person June 10–15. ACR representatives will focus on Medicare physician payment system reform, national drug shortages, funding the new Advanced Research Projects Agency for Health and more.
Prior Authorization Reform: Bill Calls for Faster Care, Fewer Denials
With 290 cosponsors, ACR-supported legislation to streamline prior authorization in Medicare Advantage plans has met a support threshold that may allow the lead sponsor to force House action.
The ACR Returns to In-Person Hill Day to Protect Patient Access to Care
More than 70 rheumatologists and rheumatology health professionals convened in Washington, D.C., to advocate on behalf of legislation that would reduce patients’ out-of-pocket drug costs and help grow America’s healthcare workforce.
New HCPCS Code Added for Anifrolumab-fnia, 1 mg
Effective for dates of service on or after April 1, the Healthcare Common Procedure Coding System (HCPCS) code J0491 is valid for billing 1 mg anifrolumab-fnia.
CVS Issues Revised Prior Authorization Forms
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.
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