Audit activity among Medicare and most third-party payers has increased in response to pressure to reduce healthcare costs. The return of billions of dollars to Medicare, Medicaid and third-party programs through these medical audit reviews has also increased. For example, the Government Accountability Office (GAO) 2014 Annual Report estimated that the Centers for Medicare &…
On May 16 and 17, ACR/ARHP leaders serving on the Board of Directors, Affiliate Society Council, Government Affairs Committee, Committee on Rheumatologic Care, RheumPAC Committee and Insurance Subcommittee once again went to Capitol Hill to advocate on behalf of ACR/ARHP members and their patients. The group represented 27 states and the District of Columbia, and…
Lurie Prize Goes to Autoimmune Researcher Zhijian “James” Chen, PhD, is this year’s recipient of the Lurie Prize in Biomedical Sciences for his 2012 discovery of the enzyme cyclic GMP-AMP synthase (cGAS). Dr. Chen received the prize at the Foundation for the National Institutes of Health Award Ceremony in May. His work revealed the paradoxical…
A recent position statement by the Society of Behavioral Medicine (SBM) concludes that patients with persistent pain need better access to psychosocial care in all healthcare settings.1 The SBM offers 10 health policy recommendations for improving such access, including removing system-related barriers, providing referral tools, reimbursing for evidence-based psychosocial approaches, prioritizing generalist-level and specialist pain…
Preventing adverse outcomes in individuals who have rheumatic diseases is a daily goal for rheumatologists. For example, rheumatologists prescribe medications and perform screening to prevent erosions in rheumatoid arthritis (RA), renal failure in systemic lupus erythematosus and flares across all diseases. Many of these actions are classified as secondary or tertiary prevention, because individuals have…
If you had asked Ray Waldrup in 1981 what he would be doing in 2018, serving as the CEO of the largest rheumatology practice in the U.S. would probably not have been his first guess. Back then, as a young college student in Georgia, Mr. Waldrup took a job at a national jewelry retailer and…
With advanced training and education, a clinical nurse specialist can be a valuable member of a patient’s healthcare team and a rheumatologist’s practice, acting as an extension of the rheumatologist to ensure a patient’s needs are met…
Greetings, Advocates! In my last update, I described the great news from February’s budget agreement that fixed Medicare’s payment adjustments so MIPS penalties would not include Part B drug costs, ensuring stabilization of the Medicare Part B drug system, among other successes. (Read the ACR’s press release on this topic.) I also described the Trump administration’s…
It’s May, and soon, most state legislatures will be adjourning for the remainder of the year. Joseph Cantrell, JD, senior manager of state affairs for the ACR, who tracks the progress of state and federal patient care legislation, reports that several states saw solid gains during 2018 state sessions, which typically run from January to…
NEW YORK (Reuters Health)—Children of women with rheumatoid arthritis (RA) who are exposed to tumor necrosis factor-alpha inhibitors (TNFis) in the womb are not at markedly increased risk of serious infections, new findings suggest. “It’s reassuring for mothers who need to take these medications during pregnancy,” Evelyne Vinet, MD, of McGill University Health Center in…