November 10-15

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Affiliate Society Council takes on emerging issues in state policy


4 minutes

The Affiliate Society Council (ASC) is a vital part of the ACR’s advocacy framework. It brings together rheumatology providers from 42 member states in order to share lessons learned, work through legislative and regulatory issues at the state level, and brainstorm solutions.

“The ACR is very engaged in policy at the state level, but a lot of times, state societies have a better feel for what the emerging issues are that we need to be paying attention to,” says Joseph Cantrell, Senior Manager of State Affairs at the ACR. “One of the most important functions of the ASC is to provide a network to communicate about those issues.”

Two of the emerging issues that were discussed at a recent meeting were copay accumulator policies and non-medical switching.

The issue of copay accumulators is one of the newer issues.

“When patients get copay assistance cards from pharmaceutical manufacturers to help pay for a drug until they meet their annual deductible, some insurers have instituted policies that are no longer counting these types of programs toward a patient’s deductible,” Mr. Cantrell said. “There was a bill in Rhode Island that would have codified that practice, but we worked in a coalition and were able to change the language to disallow the practice. The bill passed one chamber, but didn’t make it through the other in time. Still it was a better result than what we started with.”

Non-medical switching is another emerging topic that was recently discussed. It describes a practice in which insurers require patients to use prescription medications that cost the insurer less money, without considering the medical needs of the patient. Sometimes this means insurers move patients off of an effective drug onto another that may not work as well or which could adversely affect their health.

Cody Wasner, MD, a private practice rheumatologist from Eugene, OR, first learned about it from Mr. Cantrell, who had received a call about it from the National Psoriasis Foundation. The ASC also relies on relationships with other advocacy organizations, patient groups, and established coalitions to learn about issues, share information and perspective, and to be most effective.

It allowed Dr. Wasner, with a colleague, to write a letter of rebuttal to submit to his state legislature. “If we hadn’t made this connection, we wouldn’t have been able to respond back in a scientific and powerful manner,” Dr. Wasner said. “It takes a whole network to fight against things without getting blindsided.”

The ASC also helps lend state rheumatology advocates more credibility, said Christopher Adams, MD, FACP, FACR, Chair of the ACR’s Affiliate Society Council.

“Based on my experience, it helps state societies gain a lot of traction because they can say: ‘Here is our national, expert organization’s policy about this,’” Dr. Adams said. “There’s a credibility that trickles down to the local lawmakers. Our job is to influence policy, our job is not to make policy, but at the same time if we can help the ones making policy by making their lives a little easier, it’s a win-win situation.”

Manuela Marinescu, MD, a rheumatologist at Rheumatology Associates of Long Island in New York, came away from the meeting with ideas and inspiration, particularly as it relates to involving more rheumatologists in advocacy. “We really need to get more people involved, try to get the fellows thinking about it, though they are so busy that they don’t have time to learn about all these bills, but in private practice we are always exposed to this. Even if we don’t want to, we have to,” Dr. Marinescu said.

Dr. Wasner applauds the value of cooperative advocacy work, both in his own state, and through the ASC.

“Having other people to connect to from other states helps multiply the effects that you have instead of just having your own tiny little perspective. It also gives us some fellowship and motivation,” Dr. Wasner said.

More about ASC

To learn more about the ACR’s state advocacy program, stop by the Advocacy kiosk in the Discovery Center on Sunday, Monday, or Tuesday, contact Joseph Cantrell via email at [email protected], or visit