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“It is key for continual ACR advocacy to keep the focus on issues important to physicians and patients,” he said.
Dr. Harvey, who is also an assistant professor in the Department of Rheumatology at Tufts University School of Medicine in Boston, spoke during the 2016 ACR/ARHP Annual Meeting at a session updating attendees on current and ongoing legislative and regulatory issues.
A cheat sheet handed out to participants provided a quick summary of the advocacy work done in 2016 by the ACR and rheumatology advocates, including having CMS agree to add more flexibility to the MACRA payment program and allow avoidance of penalties in 2017; garnering strong bipartisan opposition to the proposed Part B drug payment program; advocating for increases in research appropriations; helping increase patient access to treatment through advocacy with payers; and supporting 11 state legislative wins— among other work.
Other highlights include growing participation by rheumatologists in advocacy work, as demonstrated by more than 7,800 emails sent to Congress on policy issues, more than 250 meetings by ACR/ARHP members in congressional offices and more than 40 RheumPAC-supported fundraisers for congressional candidates.
Update on Key Issues
Among the issues that Dr. Harvey said the ACR has been fighting to prevent “tooth and nail” is the Part B Drug payment demonstration (demo) proposed by the Centers for Medicare and Medicaid Services (CMS). Saying that passage of the Part B resolution would negatively affect some of the most vulnerable patients that rheumatologists see, Dr. Harvey said the ACR is “sparing no time, energy or expense on overturning it.” [Note: Following the Annual Meeting, these efforts appeared to pay off, with no final rule released.]
Another issue that Dr. Harvey thought could gather speed now that the Republicans will hold a majority in the Congress and given promises by President-Elect Trump to increase military spending is the need to increase investment in rheumatology research. Currently, the ACR is advocating for the creation of a $20 million dedicated arthritis research program at the Department of Defense [DOD]. “Now is the perfect time to get line-item research on arthritis through the DOD,” he said.
Dr. Harvey also emphasized that the time is right to push the incoming Congress to support efforts underway to increase biomedical research funding. Currently, the ACR is supporting $34.5 billion for the NIH in the FY 2017 Labor, Health and Human Services Appropriations Bill that includes funding of the 21st Century Cures legislation and supports $13 million for the Centers for Disease Control and Prevention Arthritis Program in the FY 2017 Labor Health and Human Services (HHS) Appropriations Bill. “Our selling point to the Republican administration is that growth in NIH funding is an investment in economic growth,” he said, adding that advocacy for increased research spending is done through telling the story of how research affects patients.
He also spoke about efforts by the ACR to help patients access specialty therapies, saying that the ACR supports the bipartisan Patients’ Access to Treatment Act (PATA) bill (H.R. 1600) that limits the amount a patient is required to pay out of pocket for infusion drugs. Currently, the bill is in the House, and the ACR is trying to get members to help introduce PATA in the Senate.
Rheumatologist participation in advocacy is growing, with more than 7,800 emails sent on policy issues …
View from the Floor
Shining a political light on what rheumatologists can expect from the new administration, Rep. John Shimkus (R-Ill.) promoted free market mechanisms to manage and solve the myriad issues raised during the session.
For example, when asked by an audience member about concerns over the high and increasing price of drugs for such diseases as lupus and rheumatoid arthritis, Rep. Shimkus agreed that the price of drugs is a valid concern, but said not to expect the Republican Congress to advocate price controls. Instead, he said that he is for more competition and more products, implying that the free market is the best way to address high drug prices.
Regarding biomedical research money and a question from the audience on where Republicans stood in terms of NIH funding, Rep. Shimkus expressed strong support for the NIH, but said if even more discretionary dollars are desired, then Congress will need help with reforming mandatory spending on such programs as Social Security and Medicare.
Speaking to the overall issue of the session on advocacy efforts by the ACR to address member concerns, Rep. Shimkus emphasized that rheumatologists, health professionals and patients need to continue work to help protect their interests, practices and patients. “The Constitution allows you to collectively organize to air grievances,” he told audience members.
A View From Above
Despite the election cries from Republications to repeal the ACA, both Dr. Harvey and Rep. Shimkus speculated that some provisions in the ACA may be retained, such as not denying coverage based on preexisting conditions and allowing dependents up to 26 years of age to be covered under their parents’ or caregivers’ insurance. Parts of the ACA that they both think will be repealed will be those that are determined through budget reconciliation, including Medicaid expansion and the insurance exchanges.
Dr. Harvey emphasized that neither extreme political approach has or will help patients. “Both parties are at the extremes currently, and we [the ACR] need to move to the middle to keep the pressure on [Congress] to get our issues addressed,” he said.
