A private insurance carrier sends an audit request letter to a rheumatology practice to review its infusion medical records for the past 30 dates of service. What information should the practice send to the carrier? Only the infusion notes The complete notes for the requested dates of service only The complete notes for the requested…
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Advocacy Leads to Legislator Access
We have often heard it said that opportunity arises from challenges. Challenge, of course, is really just a polite way of saying problem—and for our patients, problems abound when it comes to obtaining timely and affordable access to the rheumatologic care they need. Access in this context has many meanings: There is access to life-changing…
A Bridge Between Patients & Rheumatologists: What Social Workers Want Rheumatologists to Know
An integral part of the rheumatology care team, social workers can address specific issues related to a patient’s overall wellbeing. Here are some insights into how rheumatologists can better partner with social workers as part of the interdisciplinary team to ensure better patient outcomes…
CMS Rule Reflects ACR’s Advocacy, but More Patient Protections Needed
In August 2018, the Centers for Medicare and Medicaid Services (CMS) announced it would permit Medicare Advantage plans to use step therapy for Part B drugs, with a lookback period of just 108 days.1 On May 16, 2019, however, the CMS issued a final rule that extends the lookback period for Part B therapies to 365…
British Columbia Will Be First Canadian Province to Switch Patients to Biosimilars
TORONTO/MONTREAL (Reuters)—The Canadian province of British Columbia said on May 28 that its public drug plan will switch as many as 20,400 patients from three branded biologic drugs to cheap near-copies called biosimilars, saving an estimated C$96.6 million ($71.9 million) over three years. The new policy from the province’s PharmaCare program targets Johnson & Johnson’s…
Wisconsin Rheumatologist Visits Rheumatology Training Program in Nepal
A Milwaukee rheumatologist delivered lectures, participated in Grand Rounds and consulted on rheumatology treatment strategies during his visit this winter to the Patan Academy of Health Sciences (PAHS), Nepal. Paul Halverson, MD, affiliated with Froedtert Hospital and the Medical College of Wisconsin, says the several days he spent in Patan, Nepal, adjacent to Kathmandu and…
Prevent Osteoporotic Fractures with a Fracture Liaison Service
Imagine leaving the hospital after suffering a heart attack without being treated for hypertension or being started on a beta blocker. What would we think of the hospital where patients are never educated about the relationship between treating hypertension and reducing myocardial infarction and stroke risk? Unfortunately, this happens every day with osteoporosis and fractures…
What Pharmacists Want Rheumatologists to Know
Involving pharmacists in the management of chronic diseases benefits patients, says Wendy Ramey, BSPharm, RPh, CSP, a clinical pharmacy specialist in rheumatology at the University of Kentucky, Lexington. She knows this personally. As someone with rheumatoid arthritis (RA), Ms. Ramey knows pharmacists can play an important role in patient education and encouraging adherence to medications….
Employment Agreement Considerations for a New Practitioner
You are a new practitioner, ready to begin your first job, one for which you’ve been preparing for years. Your prospective employer gives you an agreement that outlines your compensation, scope of work, requirements and benefits. You are eager to start your new assignment, and you want to sign this document quickly to make your…
Rheumatology Drugs at a Glance, Part 2: Psoriasis
Over the past few years, biosimilars and other new drugs have been introduced to treat rheumatic illnesses. Some of the conditions we treat have numerous drug option; others have few or only off-label options. This series, “Rheumatology Drugs at a Glance,” provides streamlined information on the administration of biologic, biosimilar and other medications used to…
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