At the American Medical Association House of Delegates Special Meeting held Nov. 13–17, 2020, the ACR’s delegation successfully led an effort to update AMA policies on home infusion and copay accumulators.
Articles by From the College
UnitedHealthcare Delays Copay Accumulator Policy
After ACR and other provider and patient organizations expressed concerns about a proposed copay accumulator policy set to take effect Jan. 1, 2021, UnitedHealthcare has indefinitely delayed its implementation but is continuing to explore options to reduce spending on specialty drugs.
Anthem Provides Clarification on Specialty Pharmacy Mandates
The ACR recently had an opportunity to speak with Anthem leadership to follow up on concerns about specialty pharmacy acquisition mandates being implemented by Anthem plans in California and New York. Anthem clarified that they do not expect these mandates to impact community-based providers. Beginning in December 2020, Anthem plans in certain states will require…
View On-Demand Sessions & Content from ACR Convergence 2020
Content from ACR Convergence 2020, including scientific sessions, posters, exhibits, and community hubs, is available to All-Access Pass and COVID-19 Pass participants to view and access on-demand through March 11, 2021. View sessions you missed and related Q&As with the speakers, read and catch up on posters, interact with exhibits and industry events, and view…
ACR Leads Resolution to Address Copay Accumulator Policies at AMA House of Delegates Meeting
If passed, the ACR-authored resolution will direct the AMA to advocate for copay accumulator bans at state and federal levels. Several other specialties and state medical associations have joined the resolution as cosponsors.
UHC Updates Rituximab Policy to Require Use of Biosimilars
As of Oct. 1, UnitedHealthcare (UHC) requires that patients fail to respond to both FDA-approved rituximab biosimilars prior to receiving approval for rituximab. Exception: Rituximab-pvvr (Ruxience) is not FDA approved for rheumatoid arthritis.
RheumPAC Kicks Off November Matching Campaign
RheumPAC will once again conduct a matching campaign in November, coinciding with ACR Convergence 2020. During this time, all donations to RheumPAC will be amplified by leaders from the College, who will match various dollar amounts for each contribution. Additionally, many will donate a larger amount for first-time investors. Last year, matching funds contributed $91…
Hardship Exception Applications Open for Clinicians Struggling with Quality Payment Program Reporting in 2020
The Centers for Medicare & Medicaid Services have provided the opportunity to apply for exceptions for the Performance Year (PY) 2020 Quality Payment Program Merit-Based Incentive Program (MIPS) program requirements. This will help clinicians finding PY2020 MIPS federal reporting difficult due to circumstances outside their control.
UHC Announces New Copay Accumulator Policy Affecting In-Office Treatments
Editor’s note Nov. 23, 2020: As of Nov. 12, 2020, UHC has delayed implementation of the policy discussed below. See “UnitedHealthcare Delays Copay Accumulator Policy.” UnitedHealthcare (UHC) announced that, as of Jan. 1, 2021, providers will be required to report the amount their patients receive in copay assistance for office-administered treatments. UHC will then use…
ACR Urges Commercial Payers to Cover Telemedicine Beyond the Public Health Emergency
In a letter sent to commercial payers, the ACR’s Insurance Subcommittee is advocating for continued coverage for telemedicine, including reimbursement parity, after the end of the declared public health emergency.
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