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

Articles by From the College

An Important Message from the ACR on the Death of George Floyd

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The American College of Rheumatology is deeply troubled by the recent events surrounding the death of George Floyd. This tragedy is the latest in a long history of senseless killings of people of color. We recognize that racial inequality is an invisible undercurrent impacting the lives of many of our members and patients, and we…

UnitedHealthCare Rescinds Planned Changes to Orencia Policy

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UnitedHealthcare (UHC) is rescinding changes to its Orencia policy previously scheduled to go into effect July 1, 2020. These changes would have required patients to fail to respond to the self-administered formulation of the drug prior to obtaining authorization for the physician-administered product. Some patients on Orencia received notices from UHC in late April stating…

Join the ACR COVID-19 Clinical Guidance Town Hall: May 6

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In response to the recently published clinical guidance for the care of adult patients with rheumatic diseases during the COVID-19 pandemic, the ACR is hosting a virtual town hall for the rheumatology community on Wednesday, May 6, at 7–8 p.m. EDT, to review the recommendations. Moderated by ACR President Ellen M. Gravallese, MD, and ACR…

Locum Tenens as a Resource for Practices During the COVID-19 Outbreak

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As the number of COVID-19 cases continues to rise in the U.S., the fast spread of the virus is causing gaps in practice staffing, and patient influx will likely increase, leaving systems needing more providers. The use of locum tenens physicians can help practice fill gaps at your organization caused by COVID-19. Below we offer…

Coding Corner Answers: An Office Personnel Quiz

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Take the challenge. D. When an infusion is ordered by the provider, there should be a signed order from the provider. If a prior authorization is needed, it should be obtained, with the number of infusions, along with the start and end dates of the authorization. Also, a prior authorization does not guarantee reimbursement; an…

Coding Corner Questions: An Office Personnel Quiz

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A 65-year-old male patient diagnosed with rheumatoid arthritis at multiple sites without rheumatoid factor has been ordered to have infliximab infusions. What should support staff do to ensure this procedure can be given to the patient? Make sure there is a signed order from the provider Make sure a prior authorization is obtained Make sure…

Analysis of National & Local Coverage Determinations

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The Medicare statute states that items and services provided to beneficiaries must be “reasonable and necessary” to qualify for reimbursement. Although the Medicare program determines in specific cases whether an item or service is reasonable and necessary, it also issues policies, called coverage determinations, to instruct Medicare Administrative Contractors (MACs) what to reimburse providers for….