The ACR will seek Congressional action if the Medicare Part B demonstration project proposed by the Centers for Medicare & Medicaid Services (CMS) is not significantly altered by the agency. Today, Medicare Part B generally pays physicians and hospital outpatient departments the average sales price of a drug, plus a 6% add-on, minus reductions required…
The ACR and Partners Help Get Legislation Passed in New York to Limit Step Therapy
In June, state lawmakers in New York passed legislation on step therapy designed to help ensure patient access to the best and most appropriate care. Step therapy mandates that a patient with a specific condition receive prescribed drugs approved for that condition in the order that an insurance company determines it will cover as the…
U.S. Regulators Sue to Block Anthem-Cigna & Aetna-Humana Mergers
NEW YORK (Reuters)—U.S. antitrust officials on Thursday moved to block an unprecedented consolidation of the national health insurance market, filing suit against Anthem Inc.’s proposed purchase of Cigna Corp. and Aetna Inc.’s planned acquisition of Humana Inc. The U.S. Department of Justice (DOJ) says the two mergers would reduce competition, raise prices for consumers and…
ACR Advocacy at the State Level in 2016
A majority of state legislatures have concluded their work for 2016. The ACR’s state advocacy efforts continued to focus on policy benefiting rheumatologists and patients alike. The two dominant issues this year were biosimilar substitution and step therapy. Biosimilar Substitution Biosimilar substitution remains the most prevalent issue throughout the states. The ACR continues to monitor…
Medicare Advantage Grows, but Provider Choice Is Limited
CHICAGO (Reuters)—Medicare enrollees are moving in greater numbers than ever to the program’s managed care option as a way to save money. But the tradeoff is much less ability to use their preferred doctors and hospitals. Seniors can choose between traditional fee-for-service Medicare—which is accepted by most healthcare providers—or a Medicare Advantage plan. The latter…
White House Proposes Measures to Speed Genomic Test Development
WASHINGTON (Reuters)—The White House announced on Wednesday measures aimed at advancing President Barack Obama’s precision medicine initiative, including plans to speed the development of tests used to identify genetic mutations and guide medical treatment. The U.S. Food and Drug Administration said it planned to issue a proposal to create performance standards to guide development of…
U.S. Republicans Reject Democratic Funding Proposals for Opioids
WASHINGTON (Reuters) – Republican lawmakers in U.S. Congress on Wednesday rejected two Democratic amendments to provide nearly $1 billion in funding for bipartisan legislation intended to combat America’s opioid epidemic, aides said. The rejection, which came during a meeting of U.S. House of Representatives and Senate negotiators on the measure, could undermine Democratic support for…
The ACR Opposes Part B Payment Demo & Other Highlights from the AMA HOD Meeting
On June 15, the ACR and partnering physician specialist groups passed an American Medical Association (AMA) resolution opposing the proposed Medicare Part B drug payment demonstration during the AMA House of Delegates (HOD) meeting held June 11–15 in Chicago. Part B Payment Demo Resolution The resolution, which the ACR supported with the American Society of…
ACR Publishes National Research Agenda for 2016–2020
Defining new therapeutic targets and developing new therapies are among the goals of the 2016–2020 ACR National Research Agenda. So, too, is understanding early disease states, defining triggers of autoimmunity and examining disparities in access to medication and treatment.1 Charting a Course Every five years, the Committee on Research (COR) is tasked with helping chart the…
How Rheumatologists Can Engage Congress Locally, Advance Rheumatology
With limited time to spend away from your practice, you can still have an impact on issues important to Advancing Rheumatology! Below are several ways to have your voice heard, without ever leaving town. Set Up a Local Meeting with Your Elected Officials Every member of Congress has at least one local office in the…
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