The ACR’s advocacy efforts over the past year have helped bring to Congress important legislation that could have effects felt by clinics and patients around the country, but there is plenty of work ahead to push the measures across the finish line.
Leaders in government affairs for the ACR will describe this progress and needed efforts in an ACR Convergence 2021 session, Make Your Voice Count: Annual Advocacy Update, scheduled for Sunday, Nov. 7, at 11 a.m. EST.
The session will be moderated by Ryan Jessee, MD, a member of the ACR’s Government Affairs Committee (GAC) and clinical associate professor of rheumatology at Duke University School of Medicine, Durham, N.C. GAC Chair Elizabeth (Blair) Solow, MD, will talk about the strides made over the past year. Amanda Wiegrefe, the ACR director of regulatory affairs, and Lennie McDaniel, JD, the ACR director of congressional affairs, will discuss legislative challenges the College will face in the coming year. Amy Barron, RN, will discuss advocacy from a patient’s perspective, and Daniel Redinger, the ACR’s manager of advocacy and political affairs, will give attendees an “advocacy toolkit,” a basic how-to for driving policy changes meaningful to rheumatologists and patient care.
“This is a chance to celebrate our achievements as well as let people know about upcoming challenges,” Dr. Jessee says, “and then also educate members on ways, both big and small, in which they can become involved and help their profession as well as themselves from an advocacy standpoint.”
The patient’s perspective is a new addition to the annual session. “We wanted to broaden the appeal and make it clear to everyone that advocacy is something that’s done not just by providers, but patients as well,” Dr. Jessee says. “Most of our issues affect providers and patients, whether it’s access to care or being able to afford medications or see the provider you need.”
Legislative Highlights
Ms. McDaniel says the biggest advocacy accomplishment over the past year was the reintroduction of the Improving Seniors’ Timely Access to Care Act, which puts up guardrails to safeguard care that might be threatened by prior authorization requirements that force a physician to get insurer authorization before treatment can be given to a patient. Too often, she says, this process results in patients going to the pharmacy for a medication “and finding out that they can’t pick it up because the prior authorization hasn’t gone through.” This frequently leads to delays in treatment and, sometimes, in patients never getting their medication at all because they find the process too burdensome.
This bill, she says, is the “number one most talked-about piece of legislation by our members” and has been met with bipartisan support, with co-sponsorship by half of the U.S. House of Representatives as of early October. On Oct. 20, the companion bill was introduced in the Senate.
Another piece of legislation that has successfully been re-introduced—the Safe Step Act—would lessen hazards patients face with regard to step therapy requirements, in which an insurer requires a certain treatment to be tried before others, even if a patient has been on a different effective treatment for years. The legislation would create a list of exceptions to these step therapy policies to help keep patients on safe, effective treatment.
Other efforts underway include support for the Pediatric Subspecialty Loan Repayment Program, which provides incentives for rheumatologists to work in underserved areas, and work to avoid a series of cuts to Medicare reimbursement rates, which together would amount to a nearly 10% reduction for rheumatologists.
“One of the concerns this year that makes it different than every other year, where we’re having a similar fight, is that this is three different huge issues, and all three have to be dealt with differently,” Ms. McDaniel says.
Constituent Voices
Dr. Jessee and Ms. McDaniel say they hope the session continues to raise awareness of the ACR’s efforts and motivates ACR members to advocate as well, whether by contacting their representatives or sharing their views on important issues with the media.
“A member of Congress only cares what I have to say because I represent members of their actual district who vote for them,” Ms. McDaniel says. “If they’re not hearing from those people, then what I say means a lot less, and they’re less likely to take action on it.”
Dr. Jessee says education on the issues can inspire rheumatologists to get more involved, which is now easier than ever due to newly created virtual avenues. “Once people realize ‘Hey, all of these things impact my everyday practice, they impact how often I’m having to contact the insurance company, or how much I’m getting paid to see a patient on a daily basis’… that helps provide some of the motivation.”
Thomas Collins is a freelance medical writer based in Florida.
