The ACR is committed to advocating for appropriate coverage and payment policies. The volunteer members of the Insurance Subcommittee (ISC) lead this effort by representing the ACR and its membership to the insurance industry. The ISC engages payers to ensure their policies are clinically appropriate and promote patient access to high-quality care and treatment. The…
Rheumatology Coding Answer: Deconstructing Evaluation and Management Codes
Take the challenge. Answers: B: No—Only the treating physician can take the HPI. The medical assistant is allowed to take the review of systems. If the documentation indicates the treating physician did not take the HPI, the insurance can deny the claim as not medically necessary. B: No—If the high-risk medication is not assessed and…
2015 ACR/ARHP Workforce Study of Rheumatology Specialists Predicts Future Workforce Shortfall
Ten years have elapsed since the ACR conducted its last workforce study, and we know that much has changed. The comprehensive patient-centered, integrative approach to the 2015 ACR/ARHP Workforce Study of Rheumatology Specialists in the United States (now publicly available) describes the character and composition of the current clinical workforce, recognizes demographic and employment trends,…
AMA Updates Code of Medical Ethics
Eight years ago, the American Medical Association’s (AMA) Council on Ethical and Judicial Affairs embarked on a comprehensive review of the AMA Code of Medical Ethics. What emerged after years of hard effort, intensive feedback and thoughtful revisions was a modernized version of the guide, which the AMA House of Delegates voted to adopt in…
Cyber Safety in the HIPAA Age
Ready for a cyber checkup? Auditing your health IT policies, safeguarding your hardware and educating your staff on the importance of data security should be routine, according to industry experts…
Top ACR Priorities in 2017 Include Drug Costs, MACRA
With a new federal administration and Republican-controlled Congress taking the helm in 2017, the ACR Government Affairs Committee has identified top legislative and regulatory priorities for the year. “The main priority is going to be helping represent the rheumatology community as Medicare is reformed, because the era of MACRA started Jan. 1,” says Angus Worthing,…
Insurance Subcommittee to the Rescue
Concerned about reimbursement for specialty drugs? Wondering if your patient can continue on a prescribed medication despite formulary changes? Unsure how to request a tier exception? No need to face these issues alone. The ACR has a resource that can assist with questions regarding coverage and payment policies for private insurers and Medicare. That resource…
MACRA: More Points, Smarter Future
As the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is implemented in January with new models for quality-based reimbursement payments, rheumatologists must seize control of how they will be paid now—and in the future. This message was stressed by speakers during Holy MACRA! How to Survive and Thrive in the Era of MACRA,…
2015 ACR Workforce Study Report Offers Rheumatologists Chance to Improve Patient Care, Financial Outlook
I read the 2015 ACR Workforce Study Report with great interest as one who served on the 2005 Manpower Taskforce.1,2 I found it disappointing that the deficit in rheumatologist FTEs that we predicted a decade ago has become a fact. Of even greater concern, the strategies we proposed to address this problem have not been…
Self-Driven Care Can be Difficult for Adolescents Transitioning from Pediatric to Adult Rheumatology Provider
When treating adolescent patients who are making the important, sometimes bumpy crossing from a pediatric to an adult rheumatology practice, there’s no one-size-fits-all approach. “We have to be flexible on the receiving end when talking with these patients, and flexible with their families, too,” says Peter A. Nigrovic, MD, director of the Center for Adults…
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