As of July 1, a Florida bill increases oversight of pharmacy benefit managers and offers some protection for pharmacies. However, the legislation has limited effects on patients and providers, highlighting the need for additional reform.

Subcategories:EthicsLegal UpdatesLegislation & AdvocacyResearch Rheum
The ACR/CHEST ILD Guidelines in Practice, a video
In collaboration with the American College of Chest Physicians, the ACR released two new comprehensive guidelines aimed at improving the screening, monitoring, and treatment of patients with interstitial lung disease (ILD) secondary to systemic autoimmune rheumatic diseases (SARDs). Recently, Sindhu R. Johnson, MD, PhD, professor of medicine at the University of Toronto, Canada, director of the Toronto Scleroderma Program and principal investigator for the guideline, and Elana J. Bernstein, MD, MSc, Florence Irving associate professor of medicine in the Division of Rheumatology at Columbia University, New York City, and co-first author, presented a webinar to talk about how the guidelines were developed and present some of the recommendations and their rationale: Watch the recording now!

Catherine Kolonko |
As of July 1, a Florida bill increases oversight of pharmacy benefit managers and offers some protection for pharmacies. However, the legislation has limited effects on patients and providers, highlighting the need for additional reform.

Ongoing ACR advocacy efforts are working to keep biologic drugs accessible to rheumatology patients, defending the ability of rheumatology practices to use the complex chemotherapy codes for administration of biologic therapies.
Allison Plitman, MPA |
A new award from the ACR’s RISE Registry and the Rheumatology Research Foundation supports early career rheumatology researchers and clinicians who leverage the registry’s real-world data in research projects.

A prospective observational study by Syversen et al. found that patients with immune-mediated inflammatory diseases (IMID) had an attenuated serologic response to the standard two-dose vaccine regimen but a third dose was safe and effective.
Many members of Congress return to their home states and districts in August, making it a great time to engage them in local conversations about healthcare policies and how they affect rheumatology practices and patients.

Beenish Zulfiqar, MD |
It’s 11 a.m. on a Wednesday. You see a new patient in your fellow’s clinic with impressive physical findings, including a prominent skin rash and deforming arthritis. The patient has been to many doctors and is frustrated that her condition remains undiagnosed and untreated. You thoroughly examine the patient, present her case to your attending…

Joseph Cantrell, JD, & Kenneth G. Saag, MD, MSc |
The ACR and a new Access to Reproductive Health Care Task Force are working to ensure patients with rheumatic disease—particularly women—have access to the medications and treatments they need, including methotrexate, and that rheumatology providers are able to maintain trusting relationships with and advise their patients on all matters relevant to the management of their rheumatic diseases.
If enacted as is, the proposed CY 2023 Medicare Physician Fee Schedule and Quality Payment Program would make significant cuts to reimbursement for evaluation and management services, creating financial instability for providers. On a positive note, it would extend some telehealth flexibilities 151 days beyond the official end of the public health emergency.
Cigna will not move forward with changes to their reimbursement policy for evaluation and management (E/M) codes submitted with modifier 25 as originally scheduled.
All ACR and ARP members are invited to apply to join colleagues and patients in Washington, D.C., on Sept. 19–20 for advocacy training and meetings with legislators to advocate on priority issues that affect rheumatology providers and patients.