Effective for claims with dates of service on or after Oct. 1, 2017, UnitedHealthCare (UHC) plans to no longer reimburse consultation services represented by CPT codes 99241–99245 and 99251–99255. In lieu of a consultation services procedure code, UHC says it will “reimburse the appropriate evaluation and management (E/M) procedure code which describes the office visit,…
Help the ACR Bring Its Message to the Hill
The ACR will be back on Capitol Hill Sept. 26 to advocate for lower out-of-pocket costs of prescription drugs and the repeal of arbitrary Medicare therapy caps, as well as to shed light on the role of pharmacy benefit managers (PBMs) in drug pricing. But it will take the voice of all rheumatology professionals and…
ACR/ARHP Makes Another Push to Repeal Medicare Therapy Caps
H.R. 807, Medicare Access to Rehabilitation Services Act of 2017, will be one of the key issues discussed when members of the ACR’s Government Affairs Committee (GAC) visit Capitol Hill Sept. 26 during the annual Advocates for Arthritis event. This bill—as well as its companion bill in the Senate, S. 253—is aimed at repealing the…
Hyaluronidase 2 May Play an Important Role in OA Progression
A new study in mice found that Hyal2 deficiency may play a role in the turnover of cartilage hyaluronan, resulting in an accumulation of hyaluronan and, eventually, the development of osteoarthritis. Researchers suspect these results indicate an imbalance in the metabolism of hyaluronan…
Why We Advocate to Certain Congressional Committees over Others
The U.S. Congress refers to the bicameral legislature, consisting of the 435 voting and six non-voting members of the House of Representatives and the 100 members of the Senate. When we visit D.C. or express our policy positions to Congress, our message would ideally reach every member. The ultimate goal is to reach all 541…
Care Fragmentation May Increase Risk of SLE Damage & Disease Severity
Despite the wide spread adoption of electronic health records, many systems are unable to exchange data, creating the potential for fragmented care. New research examined the effect of care fragmentation on patients with SLE in the Chicago HealthLNK Data Repository, finding that care fragmentation plays an independent role in an increased frequency of infection and disease-related morbidity damage. Researchers also found a relationship between care fragmentation, race and public insurance…
CMS Announces 90% Cut to Obamacare’s Advertising Budget
WASHINGTON (Reuters)—The U.S. Centers for Medicare and Medicaid Services (CMS) said on Thursday it plans to spend $10 million on advertising for the upcoming Obamacare open enrollment period that starts in November, a sharp cut from the $100 million spent last year. The agency also said it will cut funding for so-called navigators, who help…
How to Build a Patient Base
Building a patient base takes more than marketing your rheumatology services. According to Jessica Chapman, MD, cultivating trust and communication between referring physicians and potential patients is critical…
Arizona Accuses Insys of Fraudulent Opioid Marketing Scheme
(Reuters)—Arizona’s attorney general sued Insys Therapeutics Inc on Thursday, accusing the drugmaker of engaging in a fraudulent marketing scheme aimed at increasing sales of a fentanyl-based cancer pain medicine. The lawsuit by Arizona Attorney General Mark Brnovich in Maricopa County Superior Court in Phoenix comes during a series of federal and state investigations centered on…
Opioid Use in U.S. RA Patients
Nationally, opioid use and addiction are drawing increased scrutiny. An increase in the number of overdoses and addiction to heroin and prescription pain relievers in the past decade has been attributed in part to increased prescribing of opioids for the treatment of pain by physicians. National trends suggest the rate of opioid prescribing plateaued in…
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