WASHINGTON (Reuters)—Aetna Inc.’s plan to buy smaller insurer Humana Inc. for $31 billion will mean seniors will pay higher Medicare Advantage premiums, according to a new report by the think tank Center for American Progress (CAP). Aetna’s proposed deal for Humana would combine Aetna’s 7% of the Medicare Advantage market with Humana’s 19%, and make…
U.S. Government Suspends Enrollment in Cigna Medicare Advantage, Drug Plans
(Reuters)—The U.S. government has suspended new enrollment in Cigna Corp’s Medicare Advantage health plans for seniors and standalone Medicare prescription drug plans, citing noncompliance in its appeals and grievances procedures. The government said Cigna had deficiencies in its appeals and grievances processes in both Medicare Advantage and the Medicare prescription drug program, according to a…

How to Avoid Legal Pitfalls
In busy rheumatology practices, mountains of paperwork for insurance companies and federal healthcare programs make it hard to keep track of what’s legal. Missing documentation is the most common way to spark an investigation. Here are a few considerations to help you avoid legal pitfalls…
U.S. Top Court Rejects New Challenge to Obamacare
WASHINGTON (Reuters)—The U.S. Supreme Court, which delivered major rulings in 2012 and 2015 preserving President Barack Obama’s signature healthcare law, on Tuesday declined to take up a new, long-shot challenge to Obamacare brought by an Iowa artist. The court turned away an appeal by Matt Sissel, who had asserted that the 2010 Affordable Care Act…

Patients Are Essential to Grassroots Advocacy
In 2015, ACR members were powerful advocates on important issues affecting public health and rheumatology. But we should not forget about an important resource—patients, each of whom can bring unique perspectives to legislators in Washington, D.C. Working together, our voices are stronger. Here’s how your patients can work with the ACR to advocate for their health and rheumatology…
High-Deductible Health Plan Enrollees Aren’t Shopping Around
hgh(Reuters Health)—High-deductible health insurance plans have been tied to lower healthcare spending, but a new study suggests the reason is not that enrollees in those plans are savvier. High-deductible plans have lower premiums, but when enrollees need medical care, it costs them more out-of-pocket. Researchers had expected that these patients are spending less because they’re…

Rheumatologists on the Move, January 2016
2015 Mary Betty Stevens Young Investigator Prize Awarded to Dr. Timothy Niewold Timothy B. Niewold, MD, Mayo Clinic rheumatologist and associate professor of medicine at the Mayo Clinic College of Medicine, Rochester, Minn., was awarded the 2015 Mary Betty Stevens Young Investigator Prize at a reception held during the 2015 ACR/ARHP Annual Meeting in San…

Ethics Forum: Physicians Face Ethical Quandary Discussing Poor Prognosis with Patients
Over the course of a month, you diagnose systemic sclerosis in two newly evaluated patients. Their responses to the news could not be more different. Patient 1 is a previously healthy 55-year-old man who is an avid bicyclist and skier. He presents with a several-month history of rapidly progressive skin tightening extending to the proximal…

The ACR/ARHP Award Winners Discuss Their Contributions to Rheumatology
At the 2015 ACR/ARHP Annual Meeting in San Francisco in November, the ACR and the ARHP honored a group of distinguished individuals who have made significant contributions to rheumatology research, education and patient care. In the December 2015 issue, The Rheumatologist reported on the ACR’s awards. This month, we speak with the ARHP winners about…

American Physical Therapists Collaborate with Local PTs in Ethiopia
Ethiopia has a rich, variable and distinguished history and landscape. Located in the Horn of Africa, it shares borders with Eritrea, Djibouti, Somalia, Kenya, Sudan and South Sudan. Ethiopia has claim to the oldest humanoid fossils, named “Lucy,” which were discovered in 1974 and are estimated to be 3.2 million years of age.1 The country’s…
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