Many factors make these drugs more complex than antibiotics, which is what this policy was originally intended to address, Dr. Phillips shares. “With tight margins, administration codes are a large part of what allow us to pay our nursing staff and have the facility and qualified staff to infuse these medications, which is another pressure against the bottom line.”
The Realities of Payer Policies
Dr. Phillips and Dr. Fahey agree the voice of the ISC is made stronger by members who share their concerns and complaints about payer policies that threaten rheumatology care. They encourage members to share payer experiences and concerns with the ISC.
In the year ahead, Dr. Phillips will lead the ISC in continuing advocacy work on the payer front. Stay current with these activities through ACR@Work and follow Insurance Advocacy Current Issues to find updates on pertinent policy changes and advocacy victories that impact your practice and your patients.
Carina Stanton is a freelance science journalist based in Denver.
