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.
The Biosimilar Economic Conundrum: Where We Stand
Reimbursement has fallen below acquisition price for some biosimilar versions of infliximab, forcing practices and patients to make difficult decisions. The ACR is working to change this.
Blue Cross NC Revises Autoimmune Pathways Program
After meeting with the ACR and other stakeholders, Blue Cross NC and OMI announced revisions to their Autoimmune Pathways Program to drop biologic tapering requirements and paying providers according to specific treatment decisions.
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