In recent months, the ISC has engaged with payers to reduce administrative burden on practices and continues to advocate to the CMS for the use of complex administration codes for biologics.
Prior Authorization Reform: Bill Calls for Faster Care, Fewer Denials
With 290 cosponsors, ACR-supported legislation to streamline prior authorization in Medicare Advantage plans has met a support threshold that may allow the lead sponsor to force House action.
CVS Issues Revised Prior Authorization Forms
In response to ACR and provider concerns about administrative burden, CVS Caremark has issued a streamlined version of its prior authorization forms for many biologic drugs.
ACR Leaders to Meet with Members of Congress at May 12 Capitol Hill Event
The meetings will focus on legislation affecting rheumatology, including bills on graduate medical education and use of copay assistance funds.
Update from the ACR Insurance Subcommittee
The ISC has worked with CVS Caremark to revisit changes to its prior authorization forms that would have increased the administrative burden on practices, and patients with Blue Cross Blue Shield of South Carolina may not have to worry about switching to a self-administered biologic.
Prior Authorization Is Under Review
I just couldn’t believe it. Like all of you, I receive many requests to see patients urgently. And like all of you, I can’t possibly accommodate all of those requests. So I triage: I look through the referrals and try to differentiate patients who want to be seen from those who need to be seen….
State Legislative Issues to Watch in 2022
States increasingly take the lead on issues critical to our members and the field of rheumatology, including copay accumulator bans, white bagging restrictions, prior authorization and drug pricing.
CVS Caremark to Revise Prior Authorization Forms in January 2022
The reassurance comes after ACR leadership sent a letter detailing how its prior authorization forms increased paperwork burden for many biologic drugs and hurt patients’ timely access to treatment.
Texas Establishes Gold Card for Prior Authorization Exemption
A new law in Texas establishes a continuous prior authorization exemption for physicians who earn a 90% approval rate on prior authorization requests for a given service over a period of six months.
ACR Convergence 2021: Advocacy Successes & Challenges
The ACR’s advocacy efforts over the past year have helped put critical prior authorization and step therapy legislation in front of Congress. Learn more at ACR Convergence 2021.
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