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.
Search results for: Biologics
ACR Comments on 2025 Physician Fee Schedule
The ACR’s response to the Centers for Medicare & Medicaid Services addresses the likely harm of the proposed conversion factor on the solvency and stability of rheumatology practices. The comments also include recommendations on complex drug administration coding, inflation-adjusted drug rebates and extending telehealth flexibilities.
Draft FDA Guidance No Longer Requires Biosimilar Switching Studies
The updated draft guidance, released in June, would accept an assessment of why data provided meet the switching standard to demonstrate interchangeability of biosimilars

FDA Approves 2 Upadacitinib Formulations for Children with pJIA & PsA
Upadacitinib, as a tablet and oral solution, is now FDA approved to treat children age 2 years and older with active polyarticular juvenile idiopathic arthritis or psoriatic arthritis.
Summary of Notable Provisions in CY 2025 Medicare PFS Proposed Rule
The ACR will provide comments on several provisions related to Medicare physician payment and the Quality Payment Program.

CAR-T Cell Therapy in Autoimmune Disease: The Next Frontier
Chimeric antigen receptor (CAR) T cell therapy has the potential to fundamentally shift the treatment of autoimmune disease. During his presentation at EULAR 2024, Georg Schett, MD, provided an overview of this treatment process and described the promising findings of the latest research.
ACR Successfully Leads Coalition in AMA House of Delegates to Support Higher Pediatric Specialist Compensation
An ACR-led resolution that calls for Medicaid payment parity for pediatric specialists will become AMA policy.

Pharmacy Benefit Managers Under Scrutiny
“When pharmacy benefit managers [PBMs] came into being 30 years ago, they were seen as an important component of the prescription distribution system [because] they could guide benefits and money between the patient, pharmacy and the manufacturer,” says Angus Worthing, MD, president of the Alliance for Transparent & Affordable Prescriptions (ATAP). Health insurance companies hire…

How to Effectively Diagnose & Treat Macrophage Activation Syndrome
“As a resident, [I] felt pretty terrible when [we had] a very sick child and the teams [couldn’t] agree on what to do,” said Lauren Henderson, MD, MMS, on an episode of ACR on Air. She discussed the importance of collaboration across specialties in the identification and treatment of macrophage activation syndrome (MAS).

New Indications Possible for Bimekizumab-bkzx
The FDA has accepted applications for three new indications for bimekizumab-bkzx, a humanized interleukin (IL) 17A and IL-17F antagonist: psoriatic arthritis, non-radiographic axial spondyloarthritis and ankylosing spondylitis.
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