WASHINGTON (Reuters)—Republicans delivered their biggest blow yet to Obamacare in their tax overhaul that won final congressional approval on Wednesday, and delayed until 2018 consideration of legislation that could help mitigate some of the damage to the 2010 law. The $1.5 trillion tax bill, the biggest overhaul of the U.S. tax code in three decades…
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Legislative Successes in 2017: Rheumatologists lead the push in Congress for access to care, research funding, transparency in drug pricing
SAN DIEGO—The 2017 ACR/ARHP Annual Meeting, Nov. 3–8, presented opportunities to highlight its 2017 legislative advocacy victories, some of which were resolved just weeks before the conference began, as well as issues that are still outstanding. In the session, Legislative & Regulatory Update 2017, Angus Worthing, MD, chair of the ACR’s Government Advocacy Committee and…
Rheumatology Coding Corner Answers: 2017 End-of-Year Quiz
Take the challenge. 1. B—No. CPT 99358, prolonged evaluation and management service can be billed before or after direct patient care, first hour or 99539 —each additional 30 minutes (list separately in addition to code for prolonged service). This code cannot be used to bill a higher level E/M visit code. According to 2017 CPT:…

Long-Term Benefits, Risks of Biologic Disease-Modifying Anti-Rheumatic Drugs in Patients with RA
Two decades have passed since the first biologic disease-modifying anti-rheumatic drug (bDMARD) was approved. Studies on the long-term use of biologics in different disease states, such as for cardiovascular disease (CVD) and malignancy, as well as for knee/hip replacement, reveal some encouraging news. In clinical trials, bDMARDs have been shown to increase the risk of…

Fellows’ Forum Case Report: Progressive Weakness and Debilitation with Skin Rash
The Presentation A pale, quiet woman—her mother—wheeled the girl into my clinic. It was a blistering Florida day, and the girl was shivering. She glanced up at me when I said hello and asked her name. “Hi,” she said, giving me a broad smile. Her smile was the only broad thing about her. Her elbows…

Key Findings in Basic Science This Year Hold Promise for Potential Rheumatology Therapies
SAN DIEGO—After sifting through the nitty-gritty of the rheumatic disease literature on basic science, Richard Pope, MD—professor of medicine specializing in rheumatology at Northwestern University Feinberg School of Medicine—underscored several findings he thought stood out from the pack in his Year in Review talk at the 2017 ACR/ARHP Annual Meeting. He reviewed findings from November…

How to Recognize, Diagnose Periodic Fever Syndromes in Adults
A number of autoinflammatory syndromes that result from genetic mutations have been described recently. The vast majority occur in children. However, three periodic fever syndromes are important for rheumatologists who treat adults to know about. The goal of this review is to provide a concise description of each condition, and to help the clinician understand…

Incoming ACR President Dr. David Daikh Considers Serving Organization an Honor and Privilege
Following the 2017 ACR/ARHP Annual Meeting when the formal transition in volunteer leadership occurred, my overwhelming thought has been that it is an honor and privilege to serve you as the 81st president of the ACR. Honor stems from the heritage of excellence and progress that defines this organization. Privilege comes from the opportunity to…

A History of the Science, Treatment of Rheumatologic Illnesses from Gold to Gene Therapy
Mysterious Ways The juxtaposition of the old and the new was readily evident that busy Wednesday morning. My first patient, a 94-year-old gentleman, Hal, arrived with a precise request. His rheumatologist for the past 40 years had just retired, and he was searching for a doctor with expertise in the use of gold sodium aurothioglucose,…

How to Manage, Treat Anemia of Inflammation in Patients with Rheumatic Disease
Anemia is common in patients with systemic rheumatic disease, yet it may not get the attention it deserves. Anemia can result from chronic inflammation, treatment side effects or other disease factors, or it may signal an unrelated condition. Although diagnosis and treatment of anemia are sometimes challenging, clinicians must do their utmost to rigorously investigate…
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