An ACR-led resolution that calls for the protection of NIH funding and the ability to negotiate indirect costs will become AMA policy, along with several other resolutions supported by the ACR.
Issues discussed at a meeting with the Office of Management & Budget included increasing Medicare reimbursement for physicians, telemedicine permanence, removing G2211 restrictions, adequate reimbursement for therapies and more flexibility for chemotherapy administration codes. The proposed rule is currently under review by the OMB, which is usually the last step prior to releasing publicly for stakeholder review and comment.
Signed into law in April, the legislation will ban direct and indirect PBM ownership of pharmacies, effective Jan. 1, 2026. It addresses longstanding concerns about conflicts of interest, market consolidation and patient access created by vertically integrated PBM pharmacy models.
In response to agency requests for feedback on how to streamline regulations and reduce administrative burden on Medicare program stakeholders and small business owners, the ACR called for the removal of certain regulations related to prior authorization, pharmacy benefit managers and Medicare Part B and Part D access.
Aetna recently notified practices about the launch of its Combined Benefit Management Drug List, which will result in romosozumab-aqqg (Evenity) and infliximab (Remicade) moving to pharmacy-only coverage on July 1. The ACR is working to oppose this change.
On May 6, more than 100 members of the rheumatology community participated in 118 meetings with lawmakers from 26 states—urging members of Congress to sustain research funding, address cuts and stabilize Medicare reimbursement, enact pharmacy benefit manager (PBM) reforms and protect Medicaid funding. See photos and stories from the event.
As in past administrations, members of the Executive Committee scheduled meetings with leaders of the Food & Drug Administration and Centers for Medicare & Medicaid Services to discuss ACR policy priorities and agency agendas.
The bill also enhances the state’s service cancelable loan program to help address critical shortages in the healthcare workforce. Much of the language draws from model policy previously developed by the ACR.
The May 6 event brought together patients, physicians and advocates to challenge misconceptions and advocate for sustained investment in rheumatology research.
This week, the Coalition sent Congressional leadership a letter detailing the results of a recent survey about how underwater biosimilars are impacting physicians’ ability to provide high-quality care. Almost all of the nearly 200 practices queried reported being underwater on several biosimilars, with rituximab and infliximab biosimilars being the most common.