A common case scenario in our practice in North Dakota is a woman with rheumatoid arthritis on methotrexate monotherapy. She is a member of the Sisseton Wahpeton Oyate people and lives 90 miles from our rheumatology clinic. She currently has moderate disease activity, indicating the need for additional treatment. She does not have her own…
The Insurance Subcommittee is working to address coverage and reimbursement challenges facing rheumatology practices. Recent activities include efforts to avoid increased administrative burden associated with specialty medications, support payer coverage of musculoskeletal ultrasounds and protect patient access to biologics.
Experts addressed how changes in research & clinical care can improve outcomes for children experiencing healthcare disparities during a session at the 2023 Pediatric Rheumatology Symposium.
How do healthcare providers enable positive outcomes for their pediatric patients while also addressing the disparities in care between patients of different ethnicities, gender and socioeconomic backgrounds? Experts addressed how changes in research and clinical care can improve outcomes for children experiencing healthcare disparities during a session at the 2023 Pediatric Rheumatology Symposium.
During a busy start to 2023, the ISC has been advocating with payers to address multiple coverage and reimbursement challenges facing rheumatology practices, including Cigna’s modifier 25 requirements, hydroxychloroquine access and coverage for apremilast combination therapy.
A recent meeting of the National Council of Insurance Legislators (NCOIL) featured discussions of many topics important to ACR members, including pharmacy benefit manager legislation, biomarker testing and transparency in the healthcare market.
The U.S. government remains divided. Democrats hold the White House and the Senate by one vote, and Republicans lead the House. Amid this division, the ACR is watching possible areas to advance healthcare legislation. Meet the committees and members with the largest jurisdiction over healthcare policy.
PHILADELPHIA—Quality improvement (QI) tools in pediatric rheumatology can help overcome health outcome disparities that are based on race, gender identity, income and other factors, experts said in a session at ACR Convergence. With it well established that these disparities exist, it’s time to begin eliminating them, said Emily Smitherman, MD, MS, assistant professor of pediatric…
During an ACR webinar in August, presenters discussed multiple aspects of telehealth in rheumatology, especially related to rheumatology fellowship training. They agreed that although telehealth represents one potential avenue to improve patient access to treatment for rheumatic disease, we must keep identifying the best ways to employ telehealth to enhance care. Impact of Pandemic Telemedicine…
In recent months, the ISC has engaged with payers to reduce administrative burden on practices and continues to advocate to the CMS for the use of complex administration codes for biologics.