A recent meeting of the National Council of Insurance Legislators (NCOIL) featured discussions of many topics important to ACR members, including pharmacy benefit manager legislation, biomarker testing and transparency in the healthcare market.
September Updates from the ACR Insurance Subcommittee
In recent months, the ISC has engaged with payers to reduce administrative burden on practices and continues to advocate to the CMS for the use of complex administration codes for biologics.
Advocacy Leadership Conference: Reflections from an Accidental Rheumatology Advocate
At my first Advocacy Leadership Conference as a member of the ACR’s Insurance Subcommittee, I discovered the power of stories from the clinic and how lawmakers value clinicians’ input on healthcare legislation.
Update from the ACR Insurance Subcommittee
The ISC has worked with CVS Caremark to revisit changes to its prior authorization forms that would have increased the administrative burden on practices, and patients with Blue Cross Blue Shield of South Carolina may not have to worry about switching to a self-administered biologic.
ACR Insurance Subcommittee Chair Encourages Member Engagement
Rheumatology practices have a voice in payer advocacy through the Insurance Subcommittee of the ACR’s Committee on Rheumatologic Care.
ACR Leads AMA Resolution on Payer Financial Incentives to Patients to Switch Treatment
Spurred by a recent Cigna policy, the ACR will lead a resolution to oppose insurance companies providing financial incentives for patients to switch treatments. Several specialties are cosponsoring the resolution for a special meeting of the AMA House of Delegates in June.
Why Community Rheumatologists Serve: Committee Work Pays Off ‘Many Times Over’
Volunteer leaders who are community rheumatologists share their thoughts about the professional and personal benefits of serving on ACR committees and encourage others to get involved.
Cigna Offers Patients Financial Incentive to Switch Treatments
The ACR has sent a letter to Cigna expressing opposition to the initiative, which jeopardizes patients’ health, interferes with medical decision making, undermines the doctor-patient relationship and may disproportionately affect patients of lower socioeconomic status.
ACR Urges Commercial Payers to Cover Telemedicine Beyond the Public Health Emergency
In a letter sent to commercial payers, the ACR’s Insurance Subcommittee is advocating for continued coverage for telemedicine, including reimbursement parity, after the end of the declared public health emergency.
Ethics Forum: The Ethical Considerations of Prior Authorization
The mother of a 15-year-old patient with juvenile idiopathic arthritis/enthesitis-related arthritis (JIA/ERA) called the office in tears. She said she was having an insurance problem. Her son had been a star track athlete when he developed severe back pain. Magnetic resonance imaging showed evidence of severe sacroiliitis. He was started on a tumor necrosis factor…
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