On April 1, UnitedHealthcare (UHC) announced updates to its Orencia policy, effective July 1, 2020. The change requires patients to fail to respond to the self-administered formulation of this drug prior to obtaining authorization for the physician-administered product. The ACR has been in communication with UHC about this policy since October 2019, when the payer…
Articles by From the College
CMS Releases Additional Updates to MIPS 2019 Submission
The Centers for Medicaid & Medicare Services (CMS) announced last week an extension of the 2019 Merit-Based Incentive Payment System (MIPS) reporting deadline to 8 p.m. EDT on Thursday, April 30. The extreme and uncontrollable circumstances policy has also been updated to automatically apply to any MIPS-eligible providers who do not submit data by the…
Stimulus Relief Aid for Rheumatology Practices: Details & How to Apply Now
Rheumatology practices are being hit hard by the COVID-19 pandemic. The sustainability of practices is being threatened and patient access to care is being reduced. The $2 trillion Coronavirus Aid, Relief and Economic Security (CARES) Act has numerous provisions that bring much-needed support to physicians and their practices. This includes $100 billion for healthcare providers, including physician…
Commercial Insurers Extend Coverage for Telehealth Services
The ACR has created a chart of temporary changes to commercial payers’ telehealth policies that make it easier for physicians and patients to connect without the need for an office visit.
ACR Urges Commercial Payers to Provide Relief from Prior Authorizations, Practice Disruptions
The ACR is urging insurance companies to expand access to telehealth services and provide relief from administrative burdens to help providers focus on patient care at this critical time.
ACR Advocates Against Payer Mandates on Specialty Pharmacy Acquisition of In-Office Treatments
In partnership with rheumatology and other specialty organizations, the ACR is working against payer and employer policies that mandate specialty pharmacy acquisition of in-office treatments.
2019 MIPS Deadline Extension & Policy Update
CMS has extended the deadline for 2019 MIPS submission to 8 p.m. EDT on April 30, 2020.
HHS Relaxes HIPAA Enforcement
Effective immediately, the HHS Office for Civil Rights (OCR) has stated it will not impose any noncompliance penalties under the Health Insurance Portability and Accountability Act (HIPAA) on physicians using any non-public facing service or audio or video communication technology (e.g., Apple FaceTime, Skype, Facebook Messenger, etc.) for telehealth services. This discretion applies to telehealth…
CMS Relaxes Telehealth Restrictions
President Trump announced that CMS will broaden access to telehealth services during the COVID-19 pandemic. The CMS published a fact sheet outlining the types of visits that will be covered, the providers eligible to use the expanded services and coding considerations. The ACR is working with other specialty societies and the AMA to provide additional…
March Deadlines for 2019 MIPS Submission
The last day to submit Merit-Based Incentive Payment System data via the ACR RISE registry is March 16.
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