Video: Who Am I?| Webinar: ACR/CHEST ILD Guidelines in Practice

An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

Search results for: health insurance

UnitedHealthcare to Eliminate Consultation Codes

  |  

UnitedHealthcare (UHC) announced in the March issue of its Provider Network Bulletin that it will discontinue payment for consultation codes (CPT 99241–99255) later this year. Implementation of the policy will occur in two phases. On June 1, 2019, UHC will eliminate the consultation codes for practices with contracted rates based on a stated year 2010 or…

CMS Says U.S. Health Spending to Rise 5.5% Per Year over Next Decade

Tamara Mathias and Saumya Joseph  |  

(Reuters)—U.S. health spending is expected to grow at an average rate of 5.5% every year from 2018 over the next decade and will reach nearly $6 trillion by 2027 as more people become eligible for Medicare, a government health agency said on Wednesday. Rising income levels, better employment rate and more people enrolling for Medicare,…

The ACR Has Introduced a New Reproductive Health Guideline Draft

  |  

CHICAGO—Reproductive health can be a concern for patients with rheumatic diseases, and practitioners in both disciplines often work closely together. The Reproductive Health in Rheumatic and Musculoskeletal Diseases Guideline, a draft of new clinical recommendations developed by an ACR-convened group for pregnant women, post-menopausal women, lactating women, and women and men trying to conceive or…

Sign-ups for 2019 Obamacare Insurance Fall to 8.5 Million People

Caroline Humer  |  

NEW YORK (Reuters)–The number of Americans who signed up for 2019 insurance plans created by the Affordable Care Act, often called Obamacare, fell by about 4 percent to 8.5 million people from 2018, the U.S. government said on Wednesday. Enrollment had been running about 10 percent lower but picked up during the past week, reflecting…

Walmart, Home Depot Adopt Health Insurer Tactic in Drug Copay Battle

Caroline Humer and Michael Erman  |  

NEW YORK (Reuters)—Walmart and Home Depot, two of the top 10 U.S. employers, have embraced a health insurance strategy that punishes drugmakers for using discount cards to keep patients from switching or stopping their medications. Large U.S. companies have started tightly managing how employees and their family members use these popular discount, or copay, cards…

Protect Your Practice: Action Update From the ACR’s Insurance Subcommittee

  |  

Both private and academic rheumatology practices face payer challenges that put the health of their patients and their practices at risk. To make sure the rheumatologist perspective is heard by payers, “the ACR’s Insurance Subcommittee (ISC) serves as the interface between payers and our members and ACR colleagues,” explains Sean Fahey, MD, a rheumatologist in…

UnitedHealthcare Retires Fax Numbers Used for Prior Authorization Requests

  |  

Unfortunately, prior authorization continues to be a burden for providers, practices, and patients. Effective Jan. 1, 2019, UnitedHealthcare (UHC) will retire fax numbers used for medical prior authorization (PA) requests. After this date, UHC will require PA requests to be submitted through their Prior Authorization and Notification tool. Providers who can’t submit requests electronically may…

California Insurance Commissioner Sues AbbVie over Humira

  |  

(Reuters)—On Tuesday, Insurance Commissioner Dave Jones filed a complaint on behalf of the State of California against AbbVie Inc., alleging the drugmaker gave illegal kickbacks to healthcare providers to prescribe its blockbuster drug, Humira. The regulator alleged that AbbVie engaged in a far-reaching scheme including cash, meals, drinks, gifts, trips and patient referrals, as well…

UnitedHealthcare Implementing Risk Adjustment Audit Program

  |  

Beginning in June 2018, UnitedHealthcare (UHC) will implement their risk adjustment data validation (RADV) audit program. UHC states that through the mandatory requirement by the U.S. Department of Health and Human Services (HHS), Medicare Advantage health plans will be reviewed for supporting medical documentation to check for accurately reported patient data. UHC will send requests…