As president elect of the Tennessee Medical Association (TMA), J. Eugene Huffstutter, MD, FACP, FACR, MACR, a rheumatologist with Arthritis Associates in Hixson, Tenn., says one of his priorities as the new president of the Tennessee Medical Association (TMA) is ensuring physicians can focus on practicing medicine without unnecessary obstacles. Dr. Huffstutter expresses concern about…
‘Prior authorizations are the bane of our existence as rheumatologists,’ says Physician Editor Bharat Kumar, MD, MME, FACP, FAAAAI, RhMSUS. ‘How bad is it, how can we manage them, and how is the ACR helping? Read on in this month’s Editor’s Pick.’ Healthcare providers consider prior authorization (PA) a significant burden, but to different degrees…
The reintroduction of the Improving Seniors’ Access to Care Act gives an opportunity to reduce administrative burden and undue delay of patient care imposed by prior authorization in Medicare Advantage plans. Contact your members of Congress today to urge them to pass this vital bill.
A new bill, the Improving Seniors’ Timely Access to Care Act, aims to streamline the prior authorization process. “The prior authorization process has become unmanageable for both doctors and patients. Insurer red tape imposes a significant burden on clinicians, leading to unnecessary and unclear delays, or even outright denials of patient care,” says ACR President…
Community practice rheumatology may be a less-followed path within the specialty, and it brings with it certain challenges. However, it also offers rewards, such as autonomy and deep relationships with patients. The Rheumatologist recently interviewed three community practice rheumatologists from around the U.S. to find out about their approaches to patient management, staffing and other…
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.
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.
Prior authorization and step therapy reform bills recently enacted in Pennsylvania and Massachusetts offer case studies into how substantive policy change can take persistence, patience and a bipartisan approach to achieve success.
Outgoing Government Affairs Committee Chair Blair Solow, MD, offers advocacy updates from 2022 and seasonal reflections on how to stay focused on efforts that matter when faced with daunting challenges.