Despite efforts by the ACR and other organizations, Blue Cross Blue Shield of Tennessee has indicated that it will move forward with implementation of its specialty pharmacy acquisition mandate on July 1, 2020.
Articles by From the College
RheumPAC Hosts Rep. Ami Bera (D-Calif.) for Virtual Discussion of ACR Legislative Priorities
Top RheumPAC donors attended a virtual legislative update and Q&A with Rep. Ami Bera (D-Calif.) shortly after the release of House Democrats’ $3 trillion coronavirus response plan.
UnitedHealthCare Rescinds Planned Changes to Orencia Policy
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
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
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
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
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
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….
ACR Expands Access to Education through Education Partner Program & New Spotlight Slide Decks
In conjunction with the 2019 ACR/ARP Annual Meeting, the ACR piloted two new programs to provide learners with deeper, more diverse educational experiences outside of attending medical conferences. Education Partners The ACR Education Partner Program allows rheumatology professionals to consume research from the 2019 ACR/ARP Annual Meeting via multimedia video and audio platforms. A call…
CSE Award Provides Financial Support & Creates Practice Community for Recipients
Investing in rheumatology training is essential to building a strong and capable workforce. Clinician educators are responsible for developing educational programs, instructing rheumatologists to meet accreditation standards and promoting an atmosphere of quality care for patients. Although clinician educators play a critical role in attracting the next generation of rheumatology professionals, faculty pursuing careers as…
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