Rheumatology practices are very good at navigating payer challenges, but some issues are too difficult to tackle alone. This is why the Insurance Subcommittee (ISC) of the ACR’s Committee on Rheumatologic Care (CORC) was created.
Dr. Feely
The ISC works closely with practices to learn about new payer issues and then collaborates with ACR staff to find solutions. One recent success: The ISC brought payer awareness to underwater formulary requirements for biosimilars, such as infliximab-axxq (Avsola) and infliximab-dyyb (Inflectra).
Throughout 2024 the ISC reached out to many health plans, encouraging them to change requirements or increase reimbursement. Several payers acted. The ISC is continuing this conversation with other agencies and Congress. The ISC will also keep advocating for payers to reimburse the complex care add-on code, G2211, and it will stay engaged in dialogue with major payers, such as UnitedHealthcare, as pharmacy drug list changes develop.
Incoming ISC Chair Michael Feely, MD, is eager to continue the subcommittee’s important work in his latest volunteer role with the College.
Getting to Know the New ISC Chair
Dr. Feely is an assistant professor and practicing rheumatologist at the University of Nebraska Medical Center, Omaha, where he also completed his medical training. He took his position there in 2015, after spending several years in private practice. Dr. Feely sees patients with all types of rheumatic conditions. Although most of his emphasis is clinical, he also conducts research on inflammatory myopathies. Through his work with medical students and residents, Dr. Feely is frequently engaged in training and education with rheumatology fellows.
As Dr. Feely steps into his latest ACR volunteer role as ISC chair, he took time to answer a few questions about his focus as a rheumatologist, his plans with the ISC and how he spends his time outside work.
The Rheumatologist (TR): Can you briefly explain your path to rheumatology and current professional role?
Dr. Feely: Early in my internal medicine residency, I found that I enjoyed the multisystemic nature of rheumatic diseases and the relationships developed from following patients longitudinally. Throughout my residency and fellowship, I was exposed to wonderful mentors, who helped foster my enthusiasm for the field.
TR: What previous roles have you held with the ACR, and what led you to chair the ISC?
Dr. Feely: I have completed three-year terms on the Annual Meeting Planning Committee and on the ISC and most recently was a member of the Government Affairs Committee. I have enjoyed the ACR’s role in advocating for the efficient delivery of quality rheumatologic care and found the work that the ISC performs quite valuable in helping achieve these goals.
TR: How is the ISC an important part of the ACR’s advocacy efforts?
Dr. Feely: The ISC helps providers navigate challenges posed by insurance companies that affect the delivery of care to our patients, ensuring access to necessary tests and treatments.
TR: What are your plans and priorities for the Insurance Subcommittee in the coming year?
Dr. Feely: Continue to work on ensuring access to necessary treatments and diagnostic tests, and ensuring these treatments are delivered in a way that prioritizes patients’ needs and preserves the relationship between the patient and their rheumatologist.
TR: Can you share a bit about yourself to help readers get to know you, such as family, interests or hobbies outside of work?
Dr. Feely: My wife and I have two adult children and enjoy traveling and spending time outdoors.
Dr. Feely and his colleagues serving on the ISC are eager to help rheumatologists navigate specific payer issues affecting practice. Members can connect directly with the ISC at [email protected].
Carina Stanton is a freelance science journalist based in Denver.
