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Search results for: health insurance

Spotlight on Pediatric Rheumatology in Singapore

Jason Liebowitz, MD, FACR  |  September 26, 2024

A pioneer of pediatric rheumatology in Singapore, Dr. Elizabeth Ang details her unique clinical experiences.

Filed under:ConditionsEULAR/OtherGuidanceMeeting ReportsPediatric Conditions Tagged with:ACR/APLAR ExchangeAPLAR 2024

ACR Comments on 2025 Physician Fee Schedule

From the College  |  September 6, 2024

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.

Filed under:From the CollegeLegislation & Advocacy Tagged with:ACR advocacyMedicare Physician Fee Schedule (MPFS)

Summary of Notable Provisions in CY 2025 Medicare PFS Proposed Rule

From the College  |  July 19, 2024

The ACR will provide comments on several provisions related to Medicare physician payment and the Quality Payment Program.

Filed under:Legislation & AdvocacyPractice Support Tagged with:Medicare Physician Fee Schedule (MPFS)Medicare ReimbursementQuality Payment Program (QPP)

State Copay Accumulator Legislation: An Overview

Joseph Cantrell, JD  |  June 25, 2024

As uncertainty persists around federal policies regarding copay accumulator programs, a growing number of states are stepping in. A total of 21 states have banned the programs and others are increasing transparency requirements

Filed under:Uncategorized Tagged with:copay accumulatorsstate legislation

Ethics Forum: Regarding Chatbots in Rheumatology

Biana Modilevsky, DO, & Kabita Nanda, MD  |  June 10, 2024

Chatbots are not a new concept, but have recently gained popularity and traction. Launched in late 2022, ChatGPT (Chat Generative Pre-Trained Transformer) is a web-based platform designed to simulate interactive conversations and deliver real-time data. It has quickly become a tool that provides instantaneous information that can be more focused than a Google search.1 We,…

Filed under:EthicsInsuranceTechnology Tagged with:artificial intelligencechatbotsEthics ForumHIPAA

Pharmacy Benefit Managers Under Scrutiny

Elizabeth Hofheinz, MPH, MEd  |  June 10, 2024

“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…

Filed under:Drug UpdatesLegislation & Advocacy Tagged with:drug pricingdrug pricing transparencypharmacy benefit managers (PBMs)

Ethics Forum: The Current Landscape of Artificial Intelligence in Medicine

Jeanne Gosselin, MD  |  May 6, 2024

A handful of articles on artificial intelligence (AI) have graced the pages of this publication in the past six years, including one by Bharat Kumar, MD, in November 2022. Dr. Kumar highlighted the exciting potential of AI in rheumatology, including machine learning (ML) algorithms for the prediction of response to methotrexate and a predictive model…

Filed under:EthicsPractice SupportTechnology Tagged with:artificial intelligenceDiagnosisEthics Forum

Focus on Community Practice Rheumatology

Vanessa Caceres  |  March 14, 2024

Community practice rheumatology brings with it certain challenges, but it also offers rewards, such as autonomy and the capacity to develop deep relationships with patients. Three rheumatologists discuss the challenges and rewards of private practice.

Filed under:American College of RheumatologyOpinionPractice ManagementPractice Support

The Biosimilar Economic Conundrum: Where We Stand

Carina Stanton  |  January 17, 2024

Reimbursement has fallen below acquisition price for some biosimilar versions of infliximab, forcing practices and patients to make difficult decisions. The ACR is working to change this.

Filed under:InsuranceLegislation & Advocacy Tagged with:ACR advocacyACR Insurance Subcommittee (ISC)Biosimilars

Community Practice Rheumatology Is Challenging, But Rewarding, Too

Vanessa Caceres  |  January 10, 2024

Community practice rheumatology may be a less-followed path within the specialty, and it brings with it certain challenges. However, it also offers rewards, such as autonomy and deep relationships with patients. The Rheumatologist recently interviewed three community practice rheumatologists from around the U.S. to find out about their approaches to patient management, staffing and other…

Filed under:Billing/CodingPractice SupportTechnologyWorkforce Tagged with:Advanced Practice Clinicianscommunity practiceprior authorizationstaffingtelemedicine

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