Aetna recently notified practices about the launch of its Combined Benefit Management Drug List, which will result in romosozumab-aqqg (Evenity) and infliximab (Remicade) moving to pharmacy-only coverage on July 1. The ACR is working to oppose this change.
Articles by From the College
Aetna Expands Evaluation & Management Downcoding Program
Aetna recently expanded its Claim and Code Review Program, which results in the downcoding of certain level 4 and 5 evaluation and management claims. Practices are advised to monitor remittance documents for appropriate reimbursement.
Advocates for Arthritis 2025: By the Numbers
On May 6, more than 100 members of the rheumatology community participated in 118 meetings with lawmakers from 26 states—urging members of Congress to sustain research funding, address cuts and stabilize Medicare reimbursement, enact pharmacy benefit manager (PBM) reforms and protect Medicaid funding. See photos and stories from the event.
ACR Executive Committee Holds Meetings with Heads of FDA, CMS
As in past administrations, members of the Executive Committee scheduled meetings with leaders of the Food & Drug Administration and Centers for Medicare & Medicaid Services to discuss ACR policy priorities and agency agendas.
Georgia Expands Medical Education Funding as SB 130 Becomes Law
The bill also enhances the state’s service cancelable loan program to help address critical shortages in the healthcare workforce. Much of the language draws from model policy previously developed by the ACR.
ACR, Arthritis Foundation Host Congressional Briefing to Champion Rheumatology Research
The May 6 event brought together patients, physicians and advocates to challenge misconceptions and advocate for sustained investment in rheumatology research.
Underwater Biosimilars Coalition Shares Results of Practice Survey with Congressional Leaders
This week, the Coalition sent Congressional leadership a letter detailing the results of a recent survey about how underwater biosimilars are impacting physicians’ ability to provide high-quality care. Almost all of the nearly 200 practices queried reported being underwater on several biosimilars, with rituximab and infliximab biosimilars being the most common.
Advocates for Arthritis 2025: United for the Future of Rheumatology Care
In visits to Congress members and staff, more than 120 ACR/ARP members and patients urged action to improve patient access to quality treatment. The meetings included discussions about the importance of research funding, ensuring adequate Medicare reimbursement, protecting Medicaid, and making PBMs more transparent and accountable. It’s not too late to amplify their message.
ACR Leaders Discuss Rheumatology Medications at Medicare Drug Price Negotiation Town Hall
On April 30, Rebecca Shepherd, MD, MBA, and Amanda Myers, MD, represented rheumatology in a live town hall on the Medicare Drug Price Negotiation Program, describing the benefits of apremilast and nintedanib for patients with rheumatic disease.
Advocates for Arthritis 2025: Preview of Key Issues
When ACR volunteer leaders, members and patient advocates head to Capitol Hill in May, they will urge members of Congress to protect Medicare and Medicaid against cuts, restore research funding and reform pharmacy benefit managers for better transparency and accountability.
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