If finalized, the rule would mandate that a granted prior authorization approval remains valid for the entire course of treatment for a patient in MA. If an MA plan denies coverage for a request, it must rely on a physician or expert that has expertise in the appropriate field of medicine. The agency also proposed prior authorization must be limited to only confirming the presence of a diagnosis. But provider groups want more, including gold-carding programs that exempt certain clinicians from prior authorization if they have an approval rating over a period of time.
CMS is "in the process of evaluating and updating” the Federal Independent Dispute Resolution after a federal judge struck down the process for deciding out-of-network charges.
RheumPAC is the ACR's nonpartisan PAC that works to elect and support pro-rheumatology candidates. It is the only PAC dedicated to the interests of the rheumatology profession.
OSMAPAC helps to elect state and federal candidates who have shown dedication to making positive changes to healthcare and working on behalf of the issues impacting Ohio physicians.
The Senate Health, Education, Labor and Pensions Committee held a hearing Feb. 16 on addressing the crisis. Some of the policy solutions include expanding the Graduate Medical Education program and growing teaching health centers. Sen. Bill Cassidy, MD, called for reducing doctors’ administrative burdens, thus freeing them up to provide patient care.
Senators decried the lack of transparency in the PBM market as lawmakers seek to jump-start reforms to create more probes into the industry. A number of factors contribute to a higher sense of hope of getting something anything done this session, including a desire to treat manufacturers bit more gently after they suffered several blows in last year’s Inflation Reduction Act.
Advocates and protects patient access to all appropriate treatments for rheumatic diseases
Nurtures the interest and development of students and practitioners in the field of rheumatology
Allies with other organizations involved in the advocacy and care of rheumatology patients
Enhances the quality of rheumatology services for all patients
Supports rheumatology practices regarding regulatory, financial and other matters that affect providers' ability to practice and be of service to patients with rheumatologic conditions
