Improving reimbursement for underwater biosimilars is just one example of how the ACR’s practice advocates have achieved solutions to members’ insurance challenges. Here’s a look at current ACR efforts in insurance advocacy and how to get help with your own insurance challenges.
ACR Leads Coalition Effort Opposing UHC Policy Change on G2211
In July, UHC announced it would discontinue reimbursement for G2211 for commercial plans as of Sept. 1. The ACR led a multispecialty sign-on letter urging the payer to reconsider its decision to help ensure clinicians can maintain the additional work needed to manage complex and chronic diseases.
The ACR’s Top Legislative Priority: Reforming Medicare Reimbursement
The ACR is encouraged that lawmakers are discussing Medicare physician payment reform and continues to work to educate lawmakers about the importance of both short- and long-term policy solutions. Support grassroots efforts by messaging your lawmakers today.
Ethics Forum: Regarding Chatbots in Rheumatology
Chatbots are not a new concept, but have recently gained popularity and traction. Launched in late 2022, ChatGPT (Chat Generative Pre-Trained Transformer) is a web-based platform designed to simulate interactive conversations and deliver real-time data. It has quickly become a tool that provides instantaneous information that can be more focused than a Google search.1 We,…
Insurance Denial Woes? The ACR Can Help with Appeal Letter Templates
Don’t reinvent the wheel. The ACR Committee on Rheumatologic Care offers members an updated slate of template letters to help appeal insurance denials for common off-label rheumatology treatments.
Commercial Payers Update Reimbursement for Underwater Infliximab Biosimilars
Three commercial health insurance payers have increased reimbursement for infliximab biosimilars in response to concerns that formulary requirements are leaving practices underwater.
UnitedHealthcare Updates Reimbursement for Infliximab Biosimilars
On April 1, UnitedHealthcare updated reimbursement for infliximab biosimilars in response to concerns that formulary requirements are leaving practices underwater.
Change Healthcare/Optum Cyberattack: Key Updates on Claims Disruptions & Emergency Funding
The Feb. 21 cyberattack on Change Healthcare, the clearinghouse vendor that connects providers with insurance payers, including Medicare, has caused unprecedented challenges and had a critical financial impact on payments to providers nationwide. UnitedHealthcare Group (UHG), the parent company of Change, confirmed on March 8 that it is making significant progress to restore all systems….
Updates from the ACR Insurance Subcommittee
The Insurance Subcommittee is working to address coverage and reimbursement challenges facing rheumatology practices, including issues related to biosimilar use, in-office treatments and the new G2211 code.
The ACR Advocates for G2211 Reimbursement under Medicare Advantage & Commercial Plans
The ACR is reaching out to Medicare Advantage and commercial payers to ensure appropriate reimbursement for the new complex care add-on code, G2211, implemented for outpatient office visits starting Jan. 1, 2024.
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