ACR Sets 2021 Policy Priorities for Congress, Biden Administration

The American College of Rheumatology (ACR) came out with its list of health policy priorities for 2021 that it wants the new Congress and Biden administration to focus on in order to improve access to care for patients with rheumatic diseases.

“These updated policy priorities will guide the ACR’s legislative and regulatory advocacy efforts in 2021 and ensure that we are best prepared to represent our members and the patients under their care,” said Blair Solow, MD, chair of the ACR’s Government Affairs Committee, in a statement.

The main health policy priorities that the ACR laid out included:

• Strengthening the rheumatology workforce
• Expanding access to telemedicine services for patients
• Easing prior authorization requirements that harm patients and providers
• Ensuring that reimbursements are available for rheumatology evaluation and management (E/M) services
• Increasing federal funding for rheumatology research
• And lowering the costs of prescription drugs

The ACR’s focus on strengthening the current workforce for rheumatology stems from a gradual decline in practicing rheumatologists in the United States, despite growing demand for care. The organization is urging policymakers to increase funding for Graduate Medical Education (GME), increase the number of GME spots, expand the number of fellowship training positions for rheumatologists, and establish new state-based student loan forgiveness programs to encourage rheumatologists to work in underserved areas.

Although telemedicine services and telehealth reimbursements were expanded by CMS and commercial insurers in 2020, the ACR is also pushing for policymakers to extend services, including reimbursement parity for in-office, audio-visual visits, to providers after the pandemic has ended.

Furthermore, the ACR said that it will continue to support legislation, such as HR 3107, that is meant to reduce the burden placed on patients and providers as a result of prior authorization requirements.

Additionally, the organization said that it will continue to push for a uniform electronic prior authorization process that is connects to electronic health records. Recently, CMS finalized a rule on electronic data entry that will streamline the prior authorization process and improve data transparency for providers, payers, and patients.

Medicare reimbursement for evaluation and management (E/M) services provided by rheumatologists and other cognitive specialists was updated by CMS in December 2020. The ACR said that it will continue to advocate more future E/M changes, including the creation of new codes that accurately reflect the time and expertise of E/M service providers.

In 2021, the ACR said that it will encourage Congress to increase funding for federal institutions currently researching rheumatic diseases, including arthritis, and allocate $20 million in existing funds to create a research program at the Department of Defense to investigate the impact of arthritis in military service members and veterans.

The ACR also said that it will continue to push for regulatory and legislative efforts to:

1. Give Medicare the power to negotiate with pharmaceutical companies to achieve more affordable drug prices
2. Limit out-of-pocket prescription drug costs for Medicare patients and patients with commercial insurance
3. Reduce utilization management tools used in the drug distribution systems that keep patients from accessing their medications
4. Oppose insurance policies that restrict and prevent copayment programs from supporting patient copays and deductibles
5. Streamline development and approvals for biosimilars and generic drugs

“We look forward to working collaboratively with the new Congress and Administration to advance policies that preserve and expand access high-quality care for the millions of Americans living with a rheumatic disease," said Solow.