Necrotizing autoimmune myopathy (NAM) is a relatively recently discovered subgroup of inflammatory myopathies. NAM is characterized by predominant muscle fiber necrosis and regeneration with little or no inflammation.1 One subgroup of NAM is 3-hydroxy-3-methylglutaryl-CoA reductase antibody (HMGCR Ab)-related immune-mediated necrotizing myopathy (IMNM), which occurs (rarely) after statin exposure, with a rough incidence of two per…
SAN DIEGO—At the 2017 ACR/ARHP Annual Meeting in San Diego last month, the ACR and the ARHP honored a group of distinguished individuals who have made significant contributions to rheumatology research, education and patient care. This month, The Rheumatologist speaks with the ACR winners about their individual contributions to advancing rheumatology. In coming issues, we…
Mysterious Ways The juxtaposition of the old and the new was readily evident that busy Wednesday morning. My first patient, a 94-year-old gentleman, Hal, arrived with a precise request. His rheumatologist for the past 40 years had just retired, and he was searching for a doctor with expertise in the use of gold sodium aurothioglucose,…
NEW YORK/WASHINGTON (Reuters)—For Nancy Minoui of Portland, Oregon, and Crystal Lett of Dublin, Ohio, Congress’ failure to fund the Children’s Health Insurance Program is not some distant tale of political wrangling. For Minoui, it’s about how to provide care for her daughter, Marion Burgess, born last Valentine’s Day with a hole in her heart. For…
NEW YORK (Reuters)—The number of consumers who signed up for 2018 Obamacare health insurance next year surpassed the 1 million mark in the second-to-last week of enrollment on the federally-run HealthCare.gov website, picking up the pace ahead of the December 15 deadline. Through December 9, 4.68 million consumers signed up for the insurance in the 39 states…
(Reuters)—A U.S. trade association representing medical laboratories filed a lawsuit on Monday challenging a new reimbursement system used by the federal government that it said would reduce how much Medicare pays for labs by about $670 million in 2018. The American Clinical Laboratory Association (ACLA) in a lawsuit in federal court in Washington, D.C., said…
RISE now has three means of reporting through the Merit-Based Incentive Payment System (MIPS): individual, group and the recently added virtual groups. According to the CMS, virtual groups allow individual MIPS-eligible clinicians or groups consisting of not more than 10 MIPS-eligible clinicians to join together and report as if they were a single entity. The…
The ACR and a number of other physician medical associations are lobbying for an immediate legislative fix to a piece of the MACRA law that factors high-cost Part B drugs into a rheumatology practice’s Medicare reimbursement rate through the Merit-Based Incentive Payment System (MIPS). This change, which goes into effect immediately, will impact practices in…
Medicare’s Merit-Based Incentive Payment System (MIPS) has been on a gradual incline toward requiring full participation by eligible providers. During its transition stage, reporting for the first year (2017) allowed providers the option to report as partial, full, minimum or not at all, with varying degrees of penalties and incentives across all three reporting components:…
(Reuters)—U.S. drugstore chain operator CVS Health Corp said on Sunday it had agreed to acquire U.S. health insurer Aetna Inc. for $69 billion, seeking to tackle soaring healthcare spending through lower-cost medical services in pharmacies. This year’s largest corporate acquisition will combine one of the nation’s largest pharmacy benefits managers (PBMs) and pharmacy operators with…