The ACR has partnered with the American Medical Association (AMA) and over a dozen stakeholder groups to create a set of 21 principles to reform prior authorization protocols. This coalition represents hospitals, medical groups, patients, pharmacists and physicians with a unified goal of creating a more patient-centered, streamlined and transparent process for prior authorization. According…
The Rheumatology Research Foundation is pleased to announce the overwhelming success of the Journey to Cure campaign. With a goal of raising $60 million, this five-year campaign was created to directly invest in the future of rheumatology by supporting training opportunities and funding innovative research. The campaign surpassed its goal, with a grand total of…
Editor’s note: This blog by Dr. Worthing originally appeared on the ACR’s Advocacy Listserv. What a month! House Republicans introduced their bill to repeal and replace Obamacare. The ACR has analyzed the bill and believes the American Health Care Act (AHCA) does not go far enough to help Americans with rheumatic diseases. Brief recap: The…
Implementation of the Medicare Access and Chip Reauthorization Act of 2015 (MACRA) began Jan. 1. What does this mean for rheumatologists? It means you must pick the measures by which you will be evaluated and the pace at which you will begin reporting in the Merit-Based Incentive Payment System or participating in an Advanced Alternative…
Each fall, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) puts out its Work Plan for the upcoming fiscal year to summarize its initiatives and priorities for new and ongoing work of HSS programs. Below is a summary of the key areas the OIG will focus on in 2017: Drug…
In 2016, the ACR and the Arthritis Foundation teamed up to direct $20 million within the Department of Defense’s (DoD’s) Congressionally Directed Medical Research Program (CDMRP) to arthritis treatment and prevention. The CDMRP has millions of research dollars that have not been committed to specific items. In the new appropriations cycle, we are once again…
As part of the Rheumatology Research Foundation’s Visibility Initiative, the Rheum Life campaign was developed as a way to share a patient’s perspective of what life is like with a rheumatic disease. Rheum Life also provides insight into current Foundation-funded research and the impact it will have on the lives of these patients. Exposure to…
On Jan. 31, the ACR partnered with the Arthritis Foundation to host an Arthritis 101 Congressional briefing on Capitol Hill. Panelists educated new and returning members of Congress and their staffers about arthritis and other rheumatic diseases, the cost and impact of rheumatic disease to constituents and the U.S. healthcare system, and current policy challenges…
As we begin another new year, many rheumatology practices will again receive prior authorization requests from Medicare Part D for all methotrexate prescriptions. When methotrexate is used as a chemotherapeutic drug, it’s covered by Part B, but when it’s used as an oral agent for rheumatoid arthritis, it’s covered by Part D. Early in the…
CPT: 20611-LT, J7325 X 1 ICD-9: 715.16—Osteoarthritis, localized, primary, lower leg ICD-10: M17.12—Unilateral primary osteoarthritis, left knee Note: When billing for 20611—Arthrocentesis, aspiration and/or injection, major joint or bursa (e.g., shoulder, hip, knee, subacromial bursa), with permanent recording and reporting, there must be a permanent photograph of the needle placement in the patient’s medical chart….