In early March, the Centers for Disease Control and Prevention (CDC) released a new report showing that the number of Americans living with arthritis is at an all-time high. According to the report, 54 million Americans now live with arthritis, and approximately 79 million will have arthritis by 2040. This stark picture comes at a…
Speaking Out for IPAB Repeal
On May 11, ACR President Sharad Lakhanpal, MBBS, MD, and other College members will be in Washington, D.C., to speak in support of proposed legislation or a joint resolution that would repeal the Independent Payment Advisory Board (IPAB). IPAB Defined In an attempt to control future Medicare expenditures, one element of the Patient Protection and…
CMS Notifying Clinicians of Their MIPS Status
According to the Centers for Medicare & Medicaid Services (CMS), the Medicare Administrative Contractors (MACs) that process Medicare Part B claims have begun informing providers of their participation status in the Merit-Based Incentive Payment System (MIPS). This information is coming in the form of hard-copy letters that started mailing in late April and will continue…
Institute for Clinical Economic Review Final Report on RA Treatments
On April 7, 2017, the Institute for Clinical and Economic Review (ICER) published its final report, titled, Targeted Immune Modulators for Rheumatoid Arthritis: Effectiveness & Value.1 The stated objective of the report was to assess the comparative clinical effectiveness of the targeted immune modulators (TIMs) used to treat patients with moderate to severe active rheumatoid…
Noridian Updates Tendon Injections Guidelines for Jurisdiction F
Effective May 22, 2017 Noridian has updated the Local Coverage Determination (LCD) coding guidelines for CPT procedures 20552, injection(s); single or multiple trigger point(s), 1 or 2 muscle(s) and 20553, injection(s); single or multiple trigger point(s), 3 or more used to affect therapy for a pathological condition. Noridian states the goal of the updated diagnostic…
Step Therapy and Biosimilar Substitution Top the Priority List for the Rheumatology Association of Iowa
A little more than three years ago, rheumatologist Michael Brooks, MD, FACP, FACR, Cedar Rapids, Iowa, turned years of discussion into something tangible: He and his colleagues got the paperwork and financial requirements in order and officially started the Rheumatology Association of Iowa. “We had been trying to get something going statewide in terms of…
U.S. Accuses UnitedHealth of Medicare Advantage Fraud
(Reuters)—The U.S. Justice Department (DOJ) has accused UnitedHealth Group Inc. of obtaining inflated payments from the government based on inaccurate information about the health status of patients enrolled in its largest Medicare Advantage Plan.1 The complaint, filed in federal court in Los Angeles on Monday, came after the DOJ earlier this year intervened in two…
California Asks Insurers to Double Up on Rate Filings
NEW YORK (Reuters)—Health insurers seeking regulatory approval for 2018 individual insurance plans can file two sets of premium rates as a way to deal with market uncertainty created by Republicans’ promise to repeal and replace Obamacare, a California state insurance regulator said on Friday. California Insurance Commissioner Dave Jones told insurers in a letter made…
Treating Uveitis with Adalimumab Improves Quality of Life
NEW YORK (Reuters Health)—Treatment of uveitis with adalimumab is linked with “clinically meaningful” differences in quality of life compared with treatment with placebo, new research shows. Dr. John Sheppard of Eastern Virginia Medical School in Norfolk, Va., tells Reuters Health, “Regardless of underlying etiology or lack thereof, uveitis can have a profoundly adverse effect upon…
RA Prevention: A Trial of Methotrexate Vs. Placebo in Patients with Undifferentiated Arthritis
Disease outcomes in rheumatoid arthritis (RA) have improved dramatically since the introduction of biologic agents and improved treatment strategies. Nevertheless, the majority of patients still require prolonged, if not lifelong, therapy. Therefore, the ultimate goal would be to prevent RA. This study analyzed the effect of a one-year course of methotrexate in high-risk UA patients (studied in a previous trial) after post-randomization exclusion of patients without a high risk of developing RA…
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