A new decade is upon us, and we have work to do. It is now January and Washington, D.C., is buzzing with impeachment hearings, drug pricing legislation volleyball and Democratic debates. Fortunately, Congress was able to pass spending packages to keep the federal government funded through September 2020. I have come to appreciate (read: accept) that changes in legislation on the state, federal and regulatory end take a very long time. Looking back at 2019 will help give us perspective for the year to come.
2019 Year in Review
A colossal thank you to Angus Worthing, MD, for his leadership during 2019. As we reflect on the wins in 2019, efforts by Angus, the Government Affairs Committee and ACR/ARP volunteers made them happen. Nearly 2,000 letters were sent to Congress, over 3 million #Act4Arthritis impressions were recorded, and 228 meetings occurred between legislators and ACR/ARP volunteers and patients.
We opened an office in Washington, D.C., to support the new ACR advocacy staff: Amanda Grimm Wiegrefe, director of regulatory affairs, and Dan Redinger, manager of advocacy and policy affairs. We are thrilled to have them join the team. Lennie Shewmaker, director of congressional affairs, has joined them in the new D.C. office. Adam Cooper, senior director of government affairs, and Joseph Cantrell, senior manager of state affairs, will continue their efforts in Atlanta and D.C. on behalf of ACR/ARP members, along with Rachel Myslinski, vice president of practice, advocacy and quality, and the rest of her team.
Add “make a RheumPAC donation” to your to-do list as a January resolution. These funds allow for nonpartisan meetings with lawmakers working on issues that impact rheumatology.
2020 Physician Fee Schedule Final Rule
The win: The Centers for Medicare & Medicaid Services (CMS) finalized the 2020 Physician Fee Schedule Final Rule, with rheumatologists seeing an estimated boost in reimbursement of up to 15% (to start in 2021). This was the second largest increase among all medical specialties.
Context: Each year, the CMS releases rules on physician reimbursement. They use recommendations from the AMA and the RVS Update Committee (RUC) to guide decisions on how to pay physicians from a single pot of money. Instead of compressing codes to a single code, the CMS valued certain CPT codes higher (those often used by subspecialties), added a complexity code that can be used by rheumatologists and modified documentation requirements to reduce administrative burdens. In this zero-sum game, other specialties were not so fortunate, with losses in surgery, radiology and physical therapy. The ACR has long advocated for and strongly supports the increase in rheumatologist reimbursement, but opposes the cuts in physical therapy.
