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Search results for: health insurance

Big Utilization Management Reform Wins in Pennsylvania, Massachusetts

Joseph Cantrell, JD  |  November 29, 2022

Prior authorization and step therapy reform bills recently enacted in Pennsylvania and Massachusetts offer case studies into how substantive policy change can take persistence, patience and a bipartisan approach to achieve success.

Filed under:Legislation & Advocacy Tagged with:ACR advocacyprior authorizationstate legislationstep therapyutilization management reform

ACR Scores Wins for Rheumatology Community at AMA House of Delegates Interim Meeting

From the College  |  November 17, 2022

Key successes for the rheumatology community secured by the ACR’s delegation include passage of the ACR’s resolution addressing pharmacy benefit administrators, advances in policies to protect rheumatologists and patients in the post-Dobbs landscape and retention of the rheumatology’s representation in the AMA House of Delegates.

Filed under:Legislation & Advocacy Tagged with:ACR advocacyAMA House of Delegates (HOD)third-party pharmacy benefit administrators

Ethics Forum: Has the Patient Asked for More Than Can Be Ethically Allowed?

Richard L. Allman, MD, MS, FACP, FACR  |  November 10, 2022

The patient, a 76-year-old woman, had very active polyarticular rheumatoid arthritis (RA), despite triple therapy with conventional synthetic disease-modifying anti-rheumatic drugs (DMARDs), low-dose corticosteroids and occasional intra-articular injections—the latter providing only transient symptomatic relief. She had elevated inflammatory markers and a 28-joint Disease Activity Score (DAS-28) score of 7.4.  Because of the severity of her…

Filed under:EthicsProfessional Topics Tagged with:Ethics ForumPrescription drugs

3 AC&R Study Summaries: MoCA Screening in SLE, Pediatric Social Disadvantages & Surgical Weight Loss Interventions

Oshrat E. Tayer-Shifman, MD; Kimberley Yuen, BSc, MD; Zahi Touma, MD, PhD, FACP, FACR; William Daniel Soulsby, MD; Aleksandra Kostic, BSE; Valia Leifer, MA; & Elena Losina, PhD, MSC  |  November 9, 2022

MoCA as a Screening Test in SLE Assessing the utility of the Montreal Cognitive Assessment (MoCA) By Oshrat E. Tayer-Shifman, MD, Kimberley Yuen, BSc, MD, & Zahi Touma, MD, PhD, FACP, FACR Why was this study done? Cognitive impairment is a common manifestation of systemic lupus erythematosus (SLE), with a prevalence of 40% based on…

Filed under:ConditionsResearch RheumSystemic Lupus Erythematosus Tagged with:Arthritis Care & ResearchDisparitiesObesityOsteoarthritisReading Rheum

Psoriatic Arthritis & the Obese Patient

Linda Kossoff  |  November 6, 2022

Estimates from the National Psoriasis Foundation indicate that more than 8 million people in the U.S. suffer from psoriasis and that approximately 30% of those individuals develop psoriatic arthritis (PsA).1 Given these statistics, roughly 2.4 million people in the country are likely affected by PsA. Moreover, patients with this systemic condition carry a higher-than-average burden…

Filed under:ConditionsPatient PerspectivePsoriatic Arthritis Tagged with:ObesityPsoriatic Arthritis

Bharat Kumar, MD

Exploring the Role of Artificial Intelligence in Rheumatology

Bharat Kumar, MD, MME, FACP, FAAAAI, RhMSUS  |  November 4, 2022

I looked at the joints. They spoke back to me—”I need more humanism,” they whispered. To longtime readers, those two sentences may sound both familiar and alien, perhaps even a little humorous. That’s because those sentences were generated entirely by a computer using artificial intelligence (AI). It was simple, too: I just copied the text…

Filed under:Information TechnologyOpinionRheuminationsSpeak Out RheumTechnology Tagged with:artificial intelligencebiasDiversity

Speak Out Rheum: How Did We Go So Wrong with Opioid Prescribing?

Richard Brasington Jr., MD, FACP, MACR  |  November 4, 2022

I have been listening to The Fighter Pilot Podcast because my fantasy career would have been to fly a jet fighter plane (not even remotely possible, given my constitution). I learned that when an aircraft accident occurs, a mishap board is convened, not to assign blame but to try to learn what went wrong and…

Filed under:AnalgesicsDrug UpdatesOpinionSpeak Out Rheum Tagged with:opioid crisisPain Syndrome FocusRheumSpeak Out Rheumatology

Advocacy Highlights & Fall Treats: Reflections from the GAC Chair

Elizabeth "Blair" Solow, MD  |  October 21, 2022

Outgoing Government Affairs Committee Chair Blair Solow, MD, offers advocacy updates from 2022 and seasonal reflections on how to stay focused on efforts that matter when faced with daunting challenges.

Filed under:Legislation & Advocacy Tagged with:ACR advocacydrug pricingGovernment Affairs Committee (GAC)Legislation & Advocacyprior authorizationReimbursement

With Deepest Gratitude: The ACR Appreciates Your Willing Service

From the College  |  October 21, 2022

We at the ACR acknowledge all ACR, ARP and Rheumatology Research Foundation volunteers whose committee terms are ending in November. Thank you for your valuable time and efforts toward advancing rheumatology during a challenging time. ACR: Board of Directors Kenneth G. Saag, MD, MSc; ACR President Barbara Slusher, MSW, PA-C; ARP President Anne R. Bass,…

Filed under:American College of RheumatologyFrom the College Tagged with:ACR standing committeesVolunteer

ACR Praises House for Passing Prior Authorization Reform Bill

From the College  |  October 10, 2022

WASHINGTON, D.C.—On Sept. 14, the ACR praised the House of Representatives for overwhelmingly passing bipartisan legislation intended to make it easier for Medicare Advantage beneficiaries to access the timely care they need. The Improving Seniors’ Timely Access to Care Act (H.R. 3173) passed the House on a voice vote. If enacted, the bill will create…

Filed under:From the CollegeLegislation & AdvocacyProfessional Topics Tagged with:Improving Seniors’ Timely Access to Care Actprior authorization

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