Greetings, advocates! This month’s Washington update covers how Congress’s tax proposals affect rheumatology, the ACR’s plan to fight Medicare’s adjustments to Part B drug costs in MIPS, the good news of Medicare’s new individualized biosimilar reimbursement, advances in the rheumatology-specific Alternative Payment Model and developments in Congress’s awareness about the perilous pharmacy benefit manager system….
Health Insurer Anthem Takes Pharmacy Business in House, Taps CVS to Help
(Reuters)—Health insurer Anthem Inc will start managing its billions of dollars of patient prescriptions itself in 2020, it said on Wednesday, ending a deal with Express Scripts Holding that had deteriorated into lawsuits over terms. Anthem, which sued the pharmacy benefit manager last year over claims of being overcharged by $3 billion annually, said it…
Rheumatology Advocates Visit D.C. to Act for Arthritis
The ACR/ARHP’s annual fly-in to D.C. (#Act4Arthritis) was a huge success. More than 100 ACR/ARHP members and patients from across the nation attended meetings on Capitol Hill to advocate for people living with rheumatic diseases. In all, our advocates visited 138 Senate and House offices. This year’s fly-in on Sept. 25–26 coincided with the second-annual…
Help the ACR Bring Its Message to the Hill
The ACR will be back on Capitol Hill Sept. 26 to advocate for lower out-of-pocket costs of prescription drugs and the repeal of arbitrary Medicare therapy caps, as well as to shed light on the role of pharmacy benefit managers (PBMs) in drug pricing. But it will take the voice of all rheumatology professionals and…
ATAP Holds Inaugural In-Person Meeting
The ACR recently announced the launch of the Alliance for Transparent & Affordable Prescriptions (ATAP), a coalition of provider and patient groups concerned about the role pharmacy benefit managers (PBMs) play in driving up drug costs. The inaugural ATAP in-person meeting wrapped up on July 19 in Washington, D.C. The Alliance currently consists of the…
ACR Pushes for Patient Interests, Against Spending Cuts
Greetings from Washington, D.C. Your advocacy team had another busy month. Unlike my prior updates, and in order to keep our focus on health policy, I avoid mentioning anything about Washington investigations into obstruction of justice, collusion, etc. You get enough of that elsewhere. The Healthcare Bill Obamacare repeal and reform efforts are speeding up….
Alliance Working to Rein in Power of PBMs
A coalition of patient and provider groups, including the ACR, is raising awareness about the effect of pharmacy benefit managers (PBMs) on patient care and the cost of prescription drugs. The Alliance for Transparent and Affordable Prescriptions, or ATAP, argues that too few restrictions have been placed on PBM transparency, and requirements for PBMs to…