As the United States prepares to swear in a host of new leaders in Washington, D.C., early next year, the ACR continues to advocate for policy that will help rheumatologists and other rheumatology health professionals care for patients while maintaining viable practices.
Given the serious implications legislative and regulatory decisions can have on the profession, Annual Meeting attendees are encouraged to get up-to-date on current advocacy efforts during a clinical symposium that will take place from 7:30 – 8:30 am on Tuesday in room 140A.
The session Legislative and Regulatory Update 2016 will review initiatives currently before Congress and regulatory agencies, including the Centers for Medicare and Medicaid Services and the Food and Drug Administration.
ACR Government Affairs Committee Chair William F. Harvey, MD, MSc, a rheumatologist practicing at Tufts Medical Center in Boston, MA, said the symposium will bring the membership up-to-date on the most pressing legislative and regulatory issues affecting the specialty.
Dr. Harvey, Clinical Director of the Arthritis Treatment Center and Medical Director of Clinical Informatics at Tufts Medical Center, has more than 20 years of advocacy experience. He will begin with a review of the top three legislative priorities facing the rheumatology specialty today.
“I’ll discuss H.R.1600 — the Patients’ Access to Treatment Act of 2015,” Dr. Harvey said. “This bill would limit excessive co-insurance for patients with private insurance. We are also pushing for increased access to physical therapy services by
advocating for a permanent repeal of arbitrary annual caps on physical therapy services for Medicare beneficiaries. Finally, we are advocating for increases for National Institutes of Health and Department of Defense funding related to arthritis and rheumatic diseases research.”
Dr. Harvey will also discuss high-priority regulatory issues, including the roll out of the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA). CMS released the Final Rule implementing MACRA in mid-October.
“MACRA and the CMS Part B Drug demonstration project will fundamentally change physician payments from Medicare,” he said. “We expect these regulations will radically diminish the amount physicians are paid for Medicare drugs infused in the office. This will limit access to safer, less expensive therapy for Medicare patients.
“MACRA shifts payments from a fee-for-service model to a pay-for-performance model. The rules are complicated and providers will need to act before January 1 to avoid penalties. The Part B demo, if not dramatically scaled down, may eliminate the financial viability of in-office infusions. Patients will then have to go to hospitals — where there is far less convenience and far more cost — or use in-home infusion, which is higher risk.”
As the country ends another election season and looks toward new leadership arriving in Washington, D.C., Dr. Harvey said that politicians from both parties appear to support addressing the high costs of medications; however, the unintended consequences of current policies have serious implications for physicians.
“Policies, such as the Part B demo cuts, seek to control prices on the backs of doctors and patients,” he said. “While we believe that drug prices do need to be addressed, this needs to happen independent of physician payments.”
In addition to updates from Dr. Harvey, Congressman John Shimkus (R-IL), senior member of the House Energy & Commerce Committee, will discuss the outlook under a new administration as lawmakers convene for the 115th Congress starting in January.