NEW YORK (Reuters)—Aetna Inc.’s CEO said in a letter to the U.S. Department of Justice (DOJ) during the review of its deal to buy rival Humana Inc that the insurer would exit much of the individual Obamacare insurance market if the agency challenged the merger. In the July 5 letter, Chief Executive Officer Mark Bertolini…
Prior Authorization Reform Achieves Some Success
In early August, the American Medical Association (AMA) held its annual state advocacy strategy meeting in Chicago. This meeting pulls together all state medical societies and national specialty organizations. Over three days, participants engage in roundtable discussions on issues, solutions and best practices for health policy. Networking opportunities abound. The meetings showcase legislation that has…
HIPAA Audit Activities Increase in 2016
In the coming months, rheumatologists may want to pay particular attention to their email inboxes. By the end of the year, the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) will complete stage I, phase II of a series of desk and on-site audits designed to assess providers and their business…
End of the Road: ICD-10 Grace Period Expires in October
The final milestone on the road to implementing ICD-10 (International Classification of Diseases, 10th revision) is drawing near. The 12-month grace period is scheduled to end as of Oct. 1, 2016, but that date will most likely pass with little notice, because implementation appears to have gone well since Oct. 1, 2015. “On average, it…
Aetna Pulls Back on Obamacare Health Insurance Plans in 2017
NEW YORK (Reuters)—Aetna Inc., the No. 3 U.S. health insurer, on Monday said that due to persistent financial losses on Obamacare plans, it will sell individual insurance on the government-run online marketplaces in only four states next year, down from the current 15 states. Aetna’s decision follows similar moves from UnitedHealth Group Inc. and Humana…
Rheumatology Informatics System for Effectiveness (RISE) Registry Can Help Rheumatologists Meet MACRA Requirements
The ACR has been at the forefront of helping rheumatologists meet practice demands, including federal reporting requirements. The first registry that helped meet these requirements was the Rheumatology Clinical Registry (RCR), and it facilitated quality reporting, but required manual entry of required data. More recently, ACR has contracted with FIGmd to create a tool that…
Plan Now to Attend the 2016 ACR/ARHP Annual Meeting
Where can you network with more than 16,000 professionals in the field of rheumatology? Where you can hear about promising research and best practices from industry leaders? How can you find out about new treatments and technologies on the horizon? You guessed it—at the 2016 ACR/ARHP Annual Meeting, to be held Nov. 11–16. As if…
Biochemical Insights into Progeria Syndrome Identify Bisphosphonates, Statins as Possible Candidate Drugs to Halt Aging
Can We Stay Forever Young? May your heart always be joyful And may your song always be sung May you stay forever young Forever Young —Bob Dylan Beneath the rubric of orphan diseases reside some rare conditions and others that are extraordinarily uncommon. These are the diseases that most physicians either never to get to…
Health Has Improved in States That Expanded Low-Income Insurance Options
(Reuters Health)—In states that expanded either their Medicaid programs or private insurance options for low-income Americans, beneficiaries used more outpatient and preventive care and less emergency care. They also had better subjective overall health, compared with low-income residents of states with no expanded coverage. All states participate in Medicaid, a partnership with the federal government…
E-Health, Telemedicine Pose Challenges, Offer Benefits for Patients with Arthritis
(Reuters Health)—As more and more sick patients are going online and using social media to search for answers about their health, it’s raising a lot of thorny ethical questions for doctors. “The internet and ready access to vast amounts of information are now permanent aspects of how we live our lives, including how we think…
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