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Articles tagged with "prior authorization"

Principles Would Streamline Prior Authorization Processes

Carol Patton  |  

The ACR recently partnered with the American Medical Association (AMA) and a coalition of 16 other organizations representing physicians, medical groups, hospitals, pharmacists and patients to dramatically reshape prior-authorization protocols. The coalition is urging an industry-wide reassessment of these protocols to align with a newly created set of 21 principles, called the Prior Authorization and…

Step Therapy, Biosimilars among ACR’s 2017 State-Level Priorities

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Opportunities and challenges will continue to face the rheumatology community in 2017. In response to these challenges, the ACR has outlined its federal– and state-level legislative and regulatory healthcare priorities for the year. Howard Blumstein, MD, chair of the ACR Affiliate Society Council, says that achieving at least some of these priorities at the state…

Prior Authorization Reform Achieves Some Success

Ryan Larosa, ACR staff  |  

In early August, the American Medical Association (AMA) held its annual state advocacy strategy meeting in Chicago. This meeting pulls together all state medical societies and national specialty organizations. Over three days, participants engage in roundtable discussions on issues, solutions and best practices for health policy. Networking opportunities abound. The meetings showcase legislation that has…

Prior Authorization Struggle Continues

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Many Medicare Part D plans continue to request prior authorizations for several drugs commonly prescribed by rheumatologists. The ACR has been working diligently with Robert Bennett of the Physician Regulatory Issues Team (PRIT) to avoid the same problems many physicians had last year. PRIT advises all physicians to write “for Part D” along with the diagnosis on the prescription, to verify that the drugs are for Part D diagnoses and should not be paid under Part B. This way the administrators of the prescription drug plans (PDPs) can waive the need for a new prior authorization—saving time and money for physicians, pharmacists, and the PDPs.