After significant pushback from the AMA, ACR and other medical societies, Cigna has delayed implementation of changes to its modifier 25 reimbursement policy, originally scheduled to take effect May 25.
Slow but Steady: 2023 State Legislative Progress
This legislative season has seen key pharmacy benefit manager reforms but slow movement on other issues, such as copay accumulators and utilization management. The ACR is also monitoring emerging topics, such as biomarker testing and post-public health emergency telehealth reforms.
ACR Hill Day Participants Ask Congress to Address Medical Workforce Shortage
Nearly 70 rheumatologists and rheumatology professionals convened in Washington, D.C., to advocate on behalf of legislation that would preserve and help to grow America’s healthcare workforce.
ACR Expresses Concerns with MedPAC’s Drug Pricing Recommendations
In April, the Medicare Payment Advisory Committee voted to recommend a change in the add-on payment for Part B drugs, including reducing payment for more expensive drugs. The ACR sent a letter to MedPAC expressing concerns about the significant impacts such policies would have on rheumatologists.
ACR Insurance Subcommittee Tackles Known Issues
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.
Addressing Workforce Shortages Through Public Policy
The ACR responded to a Senate Health Committee request for information with legislative strategies to support healthcare providers and expand the physician and care team pipeline.
The ACR Recommends Inflation-Based Medicare Payment Updates
In a letter to Congress, the ACR, AMA and other groups urge legislation that would provide annual inflation-based Medicare payment updates based on the full Medicare Economic Index.
The ACR Takes a Stand: How Position Statements Are Created
Through the development of position statements that lay out the ACR’s official stance on issues related to the management of rheumatic and musculoskeletal conditions, the Committee on Rheumatologic Care helps outline policies that affect the practice of rheumatology and the wellbeing and care of patients.
What to Expect in Healthcare Policy from the 2023 State Legislative Sessions
With 2023 state legislative sessions underway, early prevailing themes may forecast areas where we will see gains this year. Key issues include utilization management, copay accumulator bans, white bagging and pharmacy benefit manager reform.
Healthcare Policy Prospects in the 118th Congress
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.
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