The House of Delegates (HOD) is the policy-making body of the American Medical Association (AMA), and twice a year, representatives of all seated specialties, service societies and state medical associations review hundreds of resolutions to determine which will become AMA policies. Once those policies and priorities are determined or updated, we benefit from the AMA…
Step Therapy Legislation in the States: Navigating a Varied & Complex System
As the practice of step therapy grows more pervasive throughout the insurance industry, the protocols become increasingly confusing to navigate. Steps vary from insurer to insurer based on plan type, and formulary differences are too often based on economic incentives rather than outcome-based medicine. Patients are often left hanging in the balance while physicians’ offices…
CMS 2018 MIPS Performance Feedback, Final Score & Targeted Review Now Available
Your 2018 MIPS performance feedback and final score from the CMS are now available on the Quality Payment Program website. To learn more about performance feedback, view the frequently asked questions document from the CMS. The payment adjustment you will receive in 2020 is based on your score for the 2018 performance year. If you…
White House Scraps Proposal to Lower U.S. Drug Prices
(Reuters)—The Trump administration on Thursday scrapped one of its most ambitious proposals for lowering prescription medicine prices, backing down from a policy that would have required health insurers to pass on billions of dollars in rebates they receive from drugmakers to Medicare patients. The decision represents a new setback to President Donald Trump’s efforts to…
Upadacitinib + Methotrexate & Other csDMARDs in RA Patients
A post-hoc analysis showed upadacitinib is safe and effective for treating RA patients when used with methotrexate or non-methotrexate csDMARDs…
Adalimumab for JIA-Associated Uveitis: 5-Year Follow-up
A five-year study in patients with juvenile idiopathic arthritis-associated uveitis found drug-induced disease remission did not persist once adalimumab was stopped after long-term treatment.
Lupus Pregnancy Outcomes Improved Over the Past 2 Decades
NEW YORK (Reuters Health)—Pregnancy outcomes in women with systemic lupus erythematosus (SLE) have improved markedly over the past two decades, although pregnancy risks remain higher than in women without lupus, according to a trends analysis. “Thirty years ago, most women with SLE were advised to avoid pregnancy because of high risks for maternal and fetal…
U.S. Appeals Court to Take Up Constitutionality of Obamacare
NEW ORLEANS (Reuters)—The future of Obamacare could be at stake on Tuesday when a coalition of Democratic-led states and House of Representatives urge a federal appeals court to overturn a Texas judge’s ruling that the U.S. healthcare reform law is unconstitutional. Republicans have repeatedly tried to repeal Obamacare, or the Affordable Care Act (ACA), since…
Opioids Commonly Prescribed for Gout Attacks
NEW YORK (Reuters Health)—Nearly three in 10 patients seeking care at the emergency department (ED) for acute gout will be discharged with a prescription for opioids, new research shows. “Our study suggests a high use of prescription opioid in patients discharged from the ED with a diagnosis of gout, a condition that can be managed…
CMS Now Conducting 2017 & 2018 MIPS Data Validation Audit
CMS has begun data validation and audit for 2017 and 2018 MIPS performance years. Providers/practices selected for the audit will be notified via certified mail or email and will have 45 days from the date of notice to provide the requested information. For more information regarding the data validation criteria, visit the CMS Resource Library….
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