The high out-of-pocket costs of biologic disease modifying antirheumatic drugs (DMARDs) place “enormous financial strain” on Medicare beneficiaries and may limit therapy adherence, according to the lead author of a national investigation into Part D coverage and cost-sharing structures. Recently published online in Arthritis & Rheumatology, the study analyzed 2,737 Part D plan formularies for…
The costs of some disease-modifying therapies outpace prescription drug inflation, saddling insured patients with thousands of dollars in out-of-pocket payments and delayed or denied coverage, two new studies have shown. Disease-modifying therapies for multiple sclerosis are rising in cost five to seven times faster than inflation and cost more in the United States than in…
In today’s busy rheumatology practices, the services of nurse practitioners, physician assistants, occupational therapists and clinical nurse specialists are a great asset for patient flow, as well as increased revenue. As the growth of nonphysician providers (NPPs) in rheumatology practices has evolved, it has become increasingly important to understand the incident-to rules and avoid the…
Rheumatologists must be adequately compensated for managing patients with complex drug therapies and Medicare beneficiaries need access to biologic treatments
Referred to as -X modifiers, they are designed to define specific subsets of -59 modifier
Medicare Advantage plans, specialty tier drug spending, SGR repeal, biomedical research funding issues on lawmakers’ plates
Separate clinical quality reporting measures must be submitted for each program
Focus shifts from voluntary to punitive; makes business associates more accountable for breaches of personal health information
Survey lets physicians compare questionnaire responses with regional, national averages
A reader questions whether insurers’ practice of promoting medications has undermined physicians’ ability to provide quality patient care