(Reuters)—Drugmaker Pfizer Inc on Wednesday filed a lawsuit against Johnson and Johnson, saying its rival’s contracts with health insurers for blockbuster rheumatoid arthritis drug, Remicade, were anticompetitive and blocked sales of Pfizer’s new biosimilar. Pfizer said in the suit that Johnson and Johnson is offering discounts on its Remicade treatment in exchange for essentially excluding…
Unbudgeted: How the Opioid Crisis Is Blowing a Hole in Small-Town America’s Finances
INDIANA, Pa./CHILLICOTHE, Ohio (Reuters)—As deaths mount in America’s opioid crisis, communities on the front lines face a hidden toll: the financial cost. Ross County, a largely rural region of 77,000 people an hour south of Columbus, Ohio, is wrestling with an explosion in opioid-related deaths—44 last year compared with 19 in 2009. The drug addiction…
U.S. Democrats Urge Full Review Before Senate Vote on Latest Obamacare Attack
WASHINGTON (Reuters)—Democratic leaders in the U.S. Congress on Monday demanded that lawmakers wait to find out the budgetary and healthcare impacts of a new, last-ditch legislative effort by Republicans to repeal Obamacare before voting on it. In their long-running war on former President Barack Obama’s signature healthcare law, Senate Republicans are now proposing to replace…
Poor Sleep Associated with Higher Risk of Chronic Pain
(Reuters Health)—People who sleep poorly may be more likely to develop a chronic pain condition and have worse physical health, a study from the U.K. suggests. A general decline in both the quantity and quality of hours slept led to a two- to three-fold increase in pain problems over time, researchers found. “Sleep and pain…
Rheumatology Advocates Visit D.C. to Act for Arthritis
The ACR/ARHP’s annual fly-in to D.C. (#Act4Arthritis) was a huge success. More than 100 ACR/ARHP members and patients from across the nation attended meetings on Capitol Hill to advocate for people living with rheumatic diseases. In all, our advocates visited 138 Senate and House offices. This year’s fly-in on Sept. 25–26 coincided with the second-annual…
CMS Implements Part B Modifiers for Biosimilars
With the advent of biosimilars to the marketplace, the Centers for Medicare and Medicaid Services (CMS) now requires modifiers to identify the manufacturer of a biosimilar/biological product on Part B claims. Modifiers were put in place to provide the CMS with the necessary data needed to track claims payments, as well as the ability to…
RISE Data Use to Be Highlighted at 2017 ACR/ARHP Annual Meeting
This year’s ACR/ARHP Annual Meeting, which takes place Nov. 3–8 in San Diego, features several opportunities to learn more about the ACR’s Rheumatology Informatics System for Effectiveness (RISE) Registry, and the data and tools it offers rheumatologists. For the first time, RISE data will be presented at the Annual Meeting by rheumatologists outside of the ACR’s…
Rheumatology Coding Corner Answer: New Patient Prolonged Service Without Direct Patient Contact, Part 1
Take the Challenge. ICD-10 Codes R76.1—Raised antibody titer L20.8—Other atopic dermatitis R20.2—Paresthesia of skin R20.1—Hypoesthesia of skin CPT Codes 99358 and 99359 Rationale The Centers for Medicare & Medicaid Services (CMS) typically does not allow separate payment for physician services that do not require face-to-face time with a patient, but as of Jan. 1, 2017,…
Clinical Thought Process for Proper Medical Decision Making, Part 2
In Part 1 of this series, we covered the vital role of medical decision making in determining the final level to bill for a patient encounter. Medical decision making is the key component in coding because it reflects the intensity of the provider’s cognitive labor. This implies that there’s an unseen component involved in the…
TNF Inhibitor Drug Tapering Successful in Some Patients with RA
MADRID—Scores on the Health Assessment Questionnaire for Rheumatoid Arthritis (HAQ) and C-reactive protein (CRP) levels were independent predictors of whether patients could be tapered successfully from a TNF inhibitor after having reached remission of their RA, according to findings presented in a session at the Annual European Congress of Rheumatology. Researchers also developed a composite…
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