The long-awaited list of the first 10 Part D drugs to be included in the new Medicare Price Negotiation process includes the commonly prescribed rheumatology drugs Enbrel and Stelara. Initial negotiations with the drug manufacturers will begin this fall.
Articles by From the College
ACR on the Hill: Members Ask Congress to Reduce Barriers to Care
In late September, 80 rheumatologists, rheumatology professionals and patients living with rheumatic disease convened in Washington, D.C., for the ACR’s annual Advocates for Arthritis conference, where they marshaled in support of legislation that would reduce current barriers to care for patients.
CMS Proposes Reimbursement Cuts for CY24
On July 13, the Centers for Medicare and Medicaid Services released the CY 2024 Medicare Physician Fee Schedule Notice of Proposed Rulemaking. This annual rule outlines policies related to provider reimbursement, coverage of telehealth services, review of specific codes, refinement of evaluation and management codes and updates to the Quality Payment Program.
The ACR Opposes New AI-Based Decision-Making Platform
On July 1, Blue Cross Blue Shield of North Carolina introduced a machine-learning technology platform to make decisions about patients’ care and treatment. The ACR opposes its use on grounds that it may harm patients’ access to treatment and undermine the doctor-patient relationship.
CMS Releases CY24 Medicare Physician Fee Schedule & Quality Payment Program Updates
On July 13, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year 2024 Medicare Physician Fee Schedule and Quality Payment Program (QPP) updates. Notably, the Fee Schedule decreases the conversion factor, which coupled with reimbursement stagnation for payment updates and congressionally mandated cuts, has created financial instability for physicians across all specialties. …
Copay Accumulator & Maximizer Programs Threaten Access to Treatment
As health insurance companies and third-party benefit managers continue to use copay accumulators and maximizers to shift the cost of specialty drugs to patients, the ACR continues to advocate against programs that limit copay assistance.
Connect with Your Members of Congress in August
Legislators head home to their districts in August, providing a chance for you to engage them in personal conversations about healthcare policies and how their work affects rheumatology practices and patients.
Calling All Advocates: Advocates for Arthritis Applications Now Open
Applications are open for this year’s Advocates for Arthritis, which brings together patients and rheumatology professionals to advocate on Capitol Hill. It will be held Sept. 26–27 in Washington, D.C.
Rheumatology Priorities Advanced at Busy AMA House of Delegates Meeting
Two ACR-led resolutions on in-office specialty drug dispensing and the proposed NIH Public Access Plan passed the House of Delegates and will become AMA policy.
Open Now: New Federal Loan Repayment Program for Pediatric Rheumatologists
This program offers loan assistance of up to $100,000 to eligible pediatric medical subspecialists in exchange for a three-year, full-time service commitment at an approved facility in an underserved area. Pediatric rheumatologists are encouraged to apply.
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