The roundtable included discussions on emerging issues in state advocacy, prior authorization reform, likely impacts of the Big Beautiful Bill and physician wellness.
The National Council of Insurance Legislators (NCOIL) 2025 Summer Meeting, held July 16–19 in Chicago, Ill., included discussion of several policy issues relevant to rheumatology.
In comments to the National Association of Insurance Commissioners, the ACR outlined several recommendations for a proposed state model law addressing the use of artificial intelligence in the insurance industry.
Signed into law in April, the legislation will ban direct and indirect PBM ownership of pharmacies, effective Jan. 1, 2026. It addresses longstanding concerns about conflicts of interest, market consolidation and patient access created by vertically integrated PBM pharmacy models.
The bill also enhances the state’s service cancelable loan program to help address critical shortages in the healthcare workforce. Much of the language draws from model policy previously developed by the ACR.
With the state legislative session in full swing, the ACR is currently tracking 114 pieces of state legislation across many issue areas, including utilization management, prescription drug review boards and vaccines.
As state legislatures begin to convene their sessions in 2025, several key issues related to rheumatology are expected to take center stage, including drug costs, utilization management, telehealth and copay accumulators.
As uncertainty persists around federal policies regarding copay accumulator programs, a growing number of states are stepping in. A total of 21 states have banned the programs and others are increasing transparency requirements
The state legislative tracker shows rheumatology-related bills the ACR is actively tracking in state legislatures across the country. It lists bills by issue area and state and is regularly updated to show each bill’s progression through the legislative process.
The ACR is actively monitoring more than 60 pieces of legislation, focusing on such key issues as copay accumulators, utilization management reform, gold card programs and other emerging concerns. Two states have passed utilization management reform bills this year.