Due to the COVID-19 pandemic, the AMA House of Delegates meeting planned for June has been canceled, but the ACR’s delegation remains ready to advocate for both ongoing and new rheumatology issues, including patient protections in step therapy, prior authorization and expansion of telehealth.
The Nebraska Rheumatology Society Grows to Meet State’s Challenges
As state rheumatology societies go, the Nebraska Rheumatology Society (NRS) is one of the new kids on the block. Established two years ago, the NRS hopes to involve all 27 rheumatologists across the state. Marcus Snow, MD, a rheumatologist at the University of Nebraska Medical Center (UNMC), Omaha, says the state’s rheumatologists are spread across…
Capitol Hill Rheumatology Advocacy Goes Virtual
ACR volunteer leaders and staff will convene more than 100 meetings via teleconference with Congressional leaders on May 22, addressing rheumatology provider solvency and patient access to care amidst the COVID-19 pandemic.
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…
U.S. Supreme Court Rules for Insurers over $12 billion Obamacare Claims
WASHINGTON (Reuters)—The U.S. Supreme Court ruled in favor of health insurers seeking $12 billion from the federal government under a program set up by the Obamacare law aimed at encouraging them to offer medical coverage to previously uninsured Americans. The 8–1 ruling authored by liberal Justice Sonia Sotomayor paves the way for a significant one-time…
UnitedHealthcare to Implement Fail-First Requirement for Self-Administered Orencia
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…
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.
Experts Discuss Current Insurance Issues Challenging Rheumatology
ATLANTA—From step therapy requirements to infusion center locations to evaluation and management coding, insurance issues bring frequent headaches to clinicians and patients. Experts discussed some of the most recent concerns in a session at the 2019 ACR/ARP Annual Meeting. Chris Phillips, MD, chair of the ACR’s Insurance Subcommittee (ISC), and Gary Bryant, MD, delegate to…
The Plight of the Retail Pharmacist
She wanted me to call in an antibiotic. My sister, a lawyer, often tells me how the ethics of her profession govern even her extra-professional acts. She feels that when she was sworn into the New York State bar, she lost the freedom to bend the truth. She would never, for example, attempt to smuggle…
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