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Step Therapy Legislation in the States: Navigating a Varied & Complex System
As the practice of step therapy grows more pervasive throughout the insurance industry, the protocols become increasingly confusing to navigate. Steps vary from insurer to insurer based on plan type, and formulary differences are too often based on economic incentives rather than outcome-based medicine. Patients are often left hanging in the balance while physicians’ offices…
The Georgia Society of Rheumatology in Focus
As president of the Georgia Society of Rheumatology (GSR), Wambui Machua, MD, a rheumatologist with Piedmont Physicians Rheumatology, Atlanta, oversees a membership of 90 rheumatologists, six orthopedists, two nurses, 85 physician assistants and 27 fellows and residents. According to Dr. Machua, the GSR, founded in 1967, continues to pursue its original mission of providing educational…
The ACR’s Advocacy at State Legislature Level in 2016 Focuses on Biosimilars, Step Therapy
A majority of state legislatures have concluded their work for 2016. The ACR’s state advocacy efforts continued to focus on policy benefiting rheumatologists and patients alike. The two dominant issues this year were biosimilar substitution and step therapy. Biosimilar Substitution Biosimilar substitution remains the most prevalent issue throughout the states. The ACR continues to monitor…
Spring Review of 2021 State Legislative Progress
Bright spots from this legislative session include utilization management reform, copay accumulator bans and pharmacy benefit manager reform.