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Search results for: Biologics

Unless Congress Acts, Medicare Reimbursement Will Remain Flat or Drop in 2025

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The 2025 Medicare Physician Fee Schedule final rule, released Nov. 1, includes a conversion factor of $32.3465, a 2.83% drop from 2024. In response to advocacy efforts from the ACR and other medical societies, Congress recently introduced the Medicare Patient Access and Practice Stabilization Act of 2024, which would eliminate the 2.83% payment cut and provide an inflationary update for 2025 equal to 50% of the Medicare Economic Index.

AC&R Study Summary: Standardizing Treatment for Moderately Severe JDM

By Matthew A. Sherman, MD, MHSc, & Stacey E. Tarvin, MD, MS  |  

Why was this study done? Juvenile dermatomyositis (JDM) is the most common type of idiopathic inflammatory myopathy in childhood, and most patients have a chronic disease course requiring prolonged administration of systemic glucocorticoids and immunosuppressive agents. The initial management for patients with moderately severe JDM is relatively standardized, typically including methotrexate and systemic glucocorticoids with…

After Coalition Meeting, CMS Leadership Agrees to Closer Look at Underwater Biosimilars

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The Underwater Biosimilars Coalition shared with the Centers for Medicare & Medicaid Services concerns about problems arising from the average sales price payment methodology and discussed potential options for addressing these challenges.

How the ACR Helps with Reimbursement, Utilization Management & Other Practice Challenges

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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.