The American Medical Association and ACR Insurance Subcommittee offer support and guidance to help practices recognize and push back against downcoded payments for evaluation and management services.
Congressional Action Needed to Maintain Medicare’s Extended Telehealth Services
Medicare’s extended telehealth services will expire at the end of the year unless Congress acts to continue them. Make sure your legislators know how a failure to act will harm patient access to care.
ACR Comments on 2025 Physician Fee Schedule
The ACR’s response to the Centers for Medicare & Medicaid Services addresses the likely harm of the proposed conversion factor on the solvency and stability of rheumatology practices. The comments also include recommendations on complex drug administration coding, inflation-adjusted drug rebates and extending telehealth flexibilities.
Draft FDA Guidance No Longer Requires Biosimilar Switching Studies
The updated draft guidance, released in June, would accept an assessment of why data provided meet the switching standard to demonstrate interchangeability of biosimilars
ACR-Led Coalition on Underwater Biosimilars Grows, Charts Next Steps
New members include rheumatology state societies, specialty partners in gastroenterology and patient-facing organizations representing digestive and inflammatory diseases. The ACR and coalition partners are strategizing additional steps to ensure practices receive adequate reimbursement for biosimilars.
Urge Your Lawmakers to Support Critical Medicare Payment Reform
The recently introduced Physician Fee Stabilization Act (S. 4935) would raise the budget neutrality threshold from $20 million to $53 million and help alleviate the annual uncertainty providers face surrounding Medicare reimbursement rates.
ACR Leads Coalition Effort Opposing UHC Policy Change on G2211
In July, UHC announced it would discontinue reimbursement for G2211 for commercial plans as of Sept. 1. The ACR led a multispecialty sign-on letter urging the payer to reconsider its decision to help ensure clinicians can maintain the additional work needed to manage complex and chronic diseases.
Summary of Notable Provisions in CY 2025 Medicare PFS Proposed Rule
The ACR will provide comments on several provisions related to Medicare physician payment and the Quality Payment Program.
ACR Applauds Legislation to Reform Prior Authorization Policies
A new bill, the Improving Seniors’ Timely Access to Care Act, aims to streamline the prior authorization process. “The prior authorization process has become unmanageable for both doctors and patients. Insurer red tape imposes a significant burden on clinicians, leading to unnecessary and unclear delays, or even outright denials of patient care,” says ACR President…
ACR Successfully Leads Coalition in AMA House of Delegates to Support Higher Pediatric Specialist Compensation
An ACR-led resolution that calls for Medicaid payment parity for pediatric specialists will become AMA policy.
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