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…
White House Scraps Proposal to Lower U.S. Drug Prices
(Reuters)—The Trump administration on Thursday scrapped one of its most ambitious proposals for lowering prescription medicine prices, backing down from a policy that would have required health insurers to pass on billions of dollars in rebates they receive from drugmakers to Medicare patients. The decision represents a new setback to President Donald Trump’s efforts to…
U.S. Appeals Court to Take Up Constitutionality of Obamacare
NEW ORLEANS (Reuters)—The future of Obamacare could be at stake on Tuesday when a coalition of Democratic-led states and House of Representatives urge a federal appeals court to overturn a Texas judge’s ruling that the U.S. healthcare reform law is unconstitutional. Republicans have repeatedly tried to repeal Obamacare, or the Affordable Care Act (ACA), since…
New Wins, Ongoing Challenges for ACR Insurance Subcommittee
Corrections to reimbursement system errors with Aetna and a Medicare contractor demonstrate the latest wins for all providers by the ACR’s Insurance Subcommittee. But the committee remains hard at work advocating for rheumatologists on several fronts.
Making Sense of Drug Pricing Legislation
A number of bills have been introduced in the 116th Congress to mitigate the impact of treatment and drug costs on U.S. patients. The ACR has reviewed the bills and supports those that most closely align with its positions on access to care.
Democrats Clash on Healthcare in Scrappy First U.S. Presidential Debate
MIAMI (Reuters)—Democratic presidential contenders battled over healthcare coverage and border policy on Wednesday during a surprisingly heated first debate that laid bare the party’s divisions on whether to abolish private insurance and shift to a Medicare-for-All system. In the first round of back-to-back debates, several of the lesser-known candidates vied for attention in the crowded…
ACR Affiliate Society Council Spotlights State Efforts for Advocacy
So far it has been a busy year for the Affiliate Society Council (ASC). Forty-three states are now affiliated with the ACR through the ASC, and we may add another next year. Also, many state legislative sessions have wrapped up, so it’s a great time to provide an overview of the successes—and some of the…
ACR Pushes for Increased DXA Reimbursement
Broken hips are among the most serious injuries incurred by older adults, and many fractures are preventable. According to the Centers for Disease Control and Prevention (CDC), approximately 300,000 people over the age of 65 are hospitalized each year for hip fractures, with women (who have lower bone density than men) experiencing three-quarters of all…
Advocacy Leads to Legislator Access
We have often heard it said that opportunity arises from challenges. Challenge, of course, is really just a polite way of saying problem—and for our patients, problems abound when it comes to obtaining timely and affordable access to the rheumatologic care they need. Access in this context has many meanings: There is access to life-changing…
ACR Hill Visits Yield Key Bill Support; Plus Medicare, Biosimilar Wins
Greetings from Washington, D.C., where ACR leaders just held more than 100 meetings on Capitol Hill supporting reforms to step therapy and prior authorization, increased reimbursement for dual-energy X-ray absorptiometry (DXA), solutions to the rheumatology workforce shortage, and rheumatology-specific research at the Pentagon. We’re already hearing great news about our successes: Hours after our visit,…
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