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One thing that became clear very quickly this past year was that the COVID-19 pandemic would change the way we deliver care to patients. What has not changed amid an evolving healthcare landscape is our driving focus to ensure our patients’ access to rheumatology care and the availability of state-of-the-art treatments. We know you share that drive. By speaking with a unified voice for our patients, we can seize new opportunities presented by this unique moment.
COVID-19
The COVID-19 pandemic has highlighted new challenges and opportunities to improve our patients’ health and well-being. An example of this is in our work for vaccine access for patients.
The ACR’s clinical vaccine guidance showed that suppression of the immune system places patients at higher risk for COVID-19 infection and COVID-19-related complications, including hospitalization and death. Recognizing the high risk the coronavirus poses for our patients, the ACR took on the charge to increase rheumatic disease patient COVID-19 vaccinations. We reached out to federal and state government leaders, urging that rheumatology patients be included in earlier phases of COVID-19 vaccination programs.
We are proud that, as part of this effort, the ACR reached the governors, lieutenant governors and insurance commissioners of 46 states, making the case that immunosuppressed patients should be given priority access to COVID-19 vaccinations. We are also thankful for the support of state and local rheumatology societies that engaged in this effort with the ACR and to the hundreds of ACR/ARP members who used our grassroots platform to write to their own state policy makers directly (https://info.votervoice.net).
In the weeks following our advocacy efforts, many states opened vaccinations to immunosuppressed patients. Thankfully, today, all adult patients have access to COVID-19 vaccination, and access for children is expanding. However, the effort to increase rheumatology patient vaccination rates continues as we work with our federal partners, such as the Centers for Disease Control and Prevention (CDC), to build vaccine confidence.
In May, the ACR held a town hall on this topic, providing resources and best practices for talking with your patients about COVID-19 vaccination. You can view the town hall on our YouTube channel.
Priorities
The ACR’s membership is broad and represents all of those in the rheumatology profession who treat patients, manage rheumatology practices, do the research to discover new scientific breakthroughs, and train the rheumatologists and other professionals who will join our workforce. For each of these aspects of our community, the ACR is focused on priorities that will make a difference in the professional lives of members and, ultimately, help patients receive better care. Our advocacy priorities are focused on reducing administrative burdens, drug pricing, appropriate reimbursement, access to care and expanding research funding.
We know the frustrations caused by the increasing requirements and delays to get therapies approved for our patients. We are proud the ACR is a lead advocate for better guardrails in the use of step therapy protocols and prior authorization.
At the federal level, the ACR is advocating for passage of the Safe Step Act (S. 464/H.R. 2163), which would implement common sense reforms and guidelines for the use of step therapy, as well as the Improving Seniors’ Timely Access to Care Act, which would streamline documentation requirements for prior authorization in Medicare Advantage, ensure an electronic option and minimize prior authorizations for routinely approved medications.
At the state level, the ACR and state and local rheumatology societies are actively promoting legislation to rein in inappropriate prior authorization and step therapy rules, prohibit non-medical switching of treatments so that providers and patients can choose patients’ medications, and eliminate copay accumulator policies that make it more difficult for patients to receive treatment.
The high cost of medicines, particularly biologics, continues to be a focus of policy makers. As drug pricing legislation is considered in Congress and in state legislatures this year, the ACR is working to ensure proposals are focused on expanding patient access to treatments by addressing the underlying causes of high pharmaceutical costs to patients without hindering the provider’s ability to administer necessary treatments or the patient’s access to medications. Additionally, the ACR has been working to increase transparency of drug pricing and pharmacy benefit manager activities by supporting proposals with robust reporting requirements for rebates and drug price increases.
The ACR also continues to advocate for recognition and appropriate reimbursement for rheumatology. Our major win for rheumatology last year was the culmination of years of work to have the Medicare physician fee schedule more appropriately recognize the importance and value of rheumatology care and cognitive care specialties. We are working to protect major evaluation and management (E/M) payment updates for cognitive specialists that were implemented in January this year. The ACR is also advocating on behalf of all members of the rheumatology care team to protect our members from cuts to reimbursements for rehabilitation services.
Because of the opportunities for broadened access that telemedicine can now provide, we have pushed for expansion of telemedicine as a supplemental tool to ensure access to rheumatologic care. The ACR is pressing for greater telemedicine access and continued appropriate reimbursement for telehealth visits, including preserving payment parity for audio-only visits, and working to resolve licensing issues arising from telemedicine across state lines, as well as allowance of continued flexibilities for site-of-service requirements.
The ACR is also developing opportunities to share best practices in how providers and patients can approach the use of telemedicine post-pandemic.
