The ISC has worked with CVS Caremark to revisit changes to its prior authorization forms that would have increased the administrative burden on practices, and patients with Blue Cross Blue Shield of South Carolina may not have to worry about switching to a self-administered biologic.
MIPS Extreme & Uncontrollable Circumstances Application Reopened for 2021 MIPS Performance Year
The CMS has reopened the MIPS Extreme and Uncontrollable Circumstances applications for groups, virtual groups and Alternative Payment Model Entities are now open through March 31.
The Ins & Outs of Patient Assistance Programs
Although effective against rheumatic disease, biologic therapies come with hefty price tags. Patient assistance programs can be a useful resource to help under- and uninsured patients get the drugs they need.

Lessons from Caring for the Underinsured & Uninsured
As the first rheumatologist at a federally qualified health center in Austin, Texas, Samantha Shapiro, MD, learned several practical tips for the care of uninsured and underinsured patients with rheumatic diseases.

ACR Insurance Subcommittee Chair Encourages Member Engagement
Rheumatology practices have a voice in payer advocacy through the Insurance Subcommittee of the ACR’s Committee on Rheumatologic Care.

Electronic Consultations Could Improve Access to Rheumatologic Care
Patients shouldn’t need to exercise patience when it comes to getting needed rheumatologic care. E-consults are an evolving telehealth modality with the potential to improve access to rheumatologic care in a cost-effective and efficient manner.
2021 MIPS Reporting Submission Period Now Open
A 2021 MIPS Reporting Guide is available to help practices complete their MIPS dashboard and successfully report through the ACR’s RISE registry.

New Healthcare Price Transparency Requirements Are Complicated & Vary by State
Healthcare law is ever changing, particularly with regard to price transparency. Key healthcare leaders and stakeholders have long argued for more stringent price transparency regulations in an effort to increase patient awareness regarding the cost of a hospital item or service prior to receiving the service. Such information is anticipated to enable patients to take…
CVS Caremark to Revise Prior Authorization Forms in January 2022
The reassurance comes after ACR leadership sent a letter detailing how its prior authorization forms increased paperwork burden for many biologic drugs and hurt patients’ timely access to treatment.
Texas Establishes Gold Card for Prior Authorization Exemption
A new law in Texas establishes a continuous prior authorization exemption for physicians who earn a 90% approval rate on prior authorization requests for a given service over a period of six months.
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