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Search results for: health insurance

Unwise Choices: EHRs, PBMs, Drug Costs Are Leading to Physician Burnout

Simon M. Helfgott, MD  |  November 5, 2017

My dear electronic health records How do I dislike thee? Let me count the ways Adaptation of Sonnet 43 By Elizabeth Barrett Browning, 1806–1861 As my tenure as physician editor winds down, it’s worth reviewing some of the more nettlesome issues confronting clinicians that have been previously discussed in these pages and gauge their current…

Filed under:EMRsInsuranceOpinionPractice SupportRheuminationsSpeak Out RheumWorkforce Tagged with:burnoutCareercostsdrugEHRElectronic health recordsHealthcareinsurancepharmacy benefit managersphysicianPractice Managementrheumatologist

Obamacare Benchmark Premiums Up 37% in 2018 after Subsidy Cut-Off

Michael Erman  |  October 30, 2017

NEW YORK (Reuters)—The average monthly premium for benchmark Obamacare insurance plans will surge around 37% in 2018, the U.S. Department of Health and Human Services said on Monday, fueled by the Trump administration’s suspension of billions of dollars in subsidy payments to health insurers. The average monthly premium for the second-lowest cost “silver” plan for…

Filed under:Legislation & AdvocacyProfessional Topics Tagged with:Health InsuranceObamacareObamacare enrollmentObamacare subsidiessubsidies cut offTrump health subsidies cut

Rhode Island Doctor Pleads Guilty to Opioid Kickback Scheme

Nate Raymond  |  October 26, 2017

BOSTON (Reuters)—A Rhode Island doctor pleaded guilty on Wednesday to charges he participated in a scheme to obtain kickbacks in exchange for writing prescriptions for an addictive fentanyl-based cancer pain drug produced by Insys Therapeutics Inc. The plea by Jerrold Rosenberg came amid ongoing investigations of Insys related to Subsys, an under-the-tongue spray that contains…

Filed under:EthicsLegal Updates Tagged with:Cancerfentanyl-based cancer pain drugguilty pleahealthcare fraudInsys Therapeutics IncJerrold Rosenbergnational opioid addiction epidemicopioid crisisopioid kickback schemeRhode Island doctor

Report on EU’s Experience with Biosimilar Drugs Released: Will U.S. Experience Be Similar?

Vanessa Caceres  |  October 17, 2017

As questions about biosimilar medications swirl among U.S. rheumatologists, a recently released report sheds some light on the European experience with biosimilars—and may offer some important insights for the U.S. market. The report, Biosimilars in the EU: Information Guide for Healthcare Professionals, was released in late April by the European Medicines Agency (EMA) and the…

Filed under:Biologics/DMARDsDrug Updates Tagged with:AC&Radverse eventsAmerican College of Rheumatology (ACR)BiosimilarsBiosimilars in the EUdrugefficacyEuropeEuropean UnionfindingsinterchangeabilityMedicationoutcomepatient carepricingreportRheumatic DiseaserheumatologistsrheumatologySafetyTreatment

How Juvenile Idiopathic Arthritis Affects Patients, Families

Catherine I. Morlino  |  October 17, 2017

After having had juvenile idiopathic arthritis (JIA) for 20 years, I had a moment in my journey when I realized something new: “Your arthritis doesn’t just affect you, you know,” my sister said. This statement stopped me in my achy tracks. For two decades, I had been operating under the assumption that JIA was my…

Filed under:ConditionsOther Rheumatic Conditions Tagged with:DiagnosisfamilyJIAJuvenile idiopathic arthritisManagementpatient carequality of lifeRheumatic DiseaserheumatologistrheumatologyTreatment

Tips to Manage, Prevent Medical Billing Claim Denials

From the College  |  October 16, 2017

Physicians are increasingly fighting multiple forces in running a practice, and one of the most common barriers to effective revenue cycle management is frequent medical billing and claim denials. An insurance company’s denial for services places a significant strain on the financial process of the practice, which affects the bottom line. According to the Medical…

Filed under:Billing/CodingFrom the CollegePractice Support Tagged with:BillingclaimsCodingdenials managementErrorsHealthcareICD-10medicalPractice Managementrevenue cycle managementrheumatologist

U.S. States Plan Suit to Block Trump Obamacare Subsidies Cut

Yasmeen Abutaleb & Dan Levine  |  October 16, 2017

WASHINGTON/SAN FRANCISCO (Reuters)—On Friday, California, New York and others states vowed to sue President Donald Trump’s administration to stop him from scrapping a key component of Obamacare, subsidies to insurers that help millions of low-income people pay medical expenses, even as Trump invited Democratic leaders to negotiate a deal. One day after his administration announced…

Filed under:Legislation & AdvocacyProfessional Topics Tagged with:Health Insurancehealth insurance paymentsObamacareObamacare collapseTrump administration

What Price Glory (or, at Least, Getting Your Foot in the Door)?

Gerald Eisenberg  |  October 4, 2017

In many respects, this is the beginning of the golden age of rheumatology. Diagnostic and therapeutic approaches are now available that have radically altered for the better the lives of people with diseases that were considered virtually untreatable just a few years ago. The rheumatologist’s approach to patients with rheumatoid arthritis, the spondyloarthropathies, osteoporosis and…

Filed under:Legislation & AdvocacyProfessional Topics Tagged with:Capitol HillIllinois Bone and Joint Institute (IBJI)RheumPACRheumPAC donors

As 2018 Obamacare Deadline Nears, U.S. States Believe Every County Covered

Caroline Humer  |  September 27, 2017

NEW YORK (Reuters)—U.S. states have negotiated to the bitter end to keep health insurers selling Obamacare plans in every county next year, in some cases taking a hard-line to prevent exits that leave residents without access to health coverage. But states cannot rule out a last-minute pullout by an insurance company. Insurers must sign government…

Filed under:Legislation & Advocacy Tagged with:access to health coverageU.S. health insurers

Pfizer Files Suit Against J and J over Remicade Contracts

Caroline Humer  |  September 20, 2017

(Reuters)—Drugmaker Pfizer Inc on Wednesday filed a lawsuit against Johnson and Johnson, saying its rival’s contracts with health insurers for blockbuster rheumatoid arthritis drug, Remicade, were anticompetitive and blocked sales of Pfizer’s new biosimilar. Pfizer said in the suit that Johnson and Johnson is offering discounts on its Remicade treatment in exchange for essentially excluding…

Filed under:Legal Updates Tagged with:Johnson and JohnsonlawsuitPfizer Inc.REMICADE (infliximab)

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