Policy Change Made Reality in 2021

ACR CONVERGENCE 2021—Advocacy leaders for the ACR outlined a host of victories and challenges in a session at ACR Convergence 2021, while underscoring the importance of member involvement to help drive policy changes that will help rheumatologists and their patients.

Dr. Blair Solow

Elizabeth (Blair) Solow, MD, chair of the ACR Government Affairs Committee, outlined several big wins that resulted from the College’s advocacy efforts during the past year. Those achievements include maintenance of recent gains in evaluation and management coding in the CY2022 Medicare Physician Fee Schedule Final Rule, as well as extended flexibilities for telehealth and acceptance of the rheumatology-specific Merit-Based Incentive Payment System (MIPS) Value Pathway, which will simplify rheumatologists’ participation in MIPS.

In addition, the Pediatric Subspecialty Loan Repayment Program was reauthorized this year, with $25 million proposed to fund the program for the first time. “If we can get this through appropriations, this will be a huge win for our pediatric colleagues,” Dr. Solow said.

Advocacy Hill Days in May and September—attended by nearly 200 ACR members, rheumatology professionals and patients in total—were particularly effective, Dr. Solow said. Groups spoke with members of Congress and their staff about step therapy, prior authorization policies, and drug pricing issues and their effects on practices and patient access to care. Since those meetings took place, ACR staff and volunteer leaders have noted increased awareness and co-signers on related bills. 

Current efforts are directed toward blocking the significant cuts to Medicare reimbursement scheduled to take effect at the beginning of 2022. Lennie McDaniel, JD, director of congressional regulatory affairs for the ACR, said the College is working to avoid these cuts, which would amount to nearly a 10% reduction in Medicare reimbursement rates for providers, including rheumatologists.

Dr. Solow encouraged all providers to send letters to their representatives to support a legislative fix for these cuts, saying, “This is incredibly important to move the needle and push these policies forward.”

Looking Ahead

With the focus of Congress over the past several months on big spending bills that are the cornerstone of President Biden’s agenda, there has not been much opportunity to focus on other, more specific legislation, Ms. McDaniel noted.

“Our hope is once we turn over the new year, those things will have been resolved and we can go back to focusing on some of the more one-off, specific topics that really drill down and deal with issues specific to day-to-day practice and patient care,” she said.