Thank you for Attending the 2023 WRA Annual Meeting!

Save the Date and plan to join us next year!
September 13-15, 2024


Dear Colleagues,

We are looking forward to gathering in person for the Washington Rheumatology Alliance Annual Meeting! Once again, we will be hosting the event at the charming Sleeping Lady Resort in the beautiful Cascade Mountains. Please join us from Friday, September 22nd – Sunday, September 24th, 2023.

Pre-registration is closed as of September 18, 2023. If you would like to attend this meeting, please come to the registration desk for on-site registration. On-site registration begins on Saturday morning, September 23, 2023 at 7:00 am.


Attendees and guest speakers are welcomed to stay on site at Sleeping Lady Resort. We request that industry representatives stay at the Icicle Village Resort (just a few miles away from the conference venue) in the Bavarian-themed village of Leavenworth. There will be a discounted room block available.

If you are interested in exhibiting at the annual event, please complete the following form:
Exhibitor Interest Form

We look forward to seeing you this summer! Thank you for your continued support of the WRA.

Jeff Peterson, MD

WRA President

TAKE ACTION: Sign in ‘PRO’ to Share the Savings!

Washington’s own Share the Savings bill (SB 5445, HB 1465) is a measure that will help lower the cost of prescription drugs for patients throughout the state.

Share the Savings will improve the lives of Washingtonians who may struggle to cover out-of-pocket costs for medications and treatments by requiring health insurance companies and pharmacy benefit managers (PBMs) to share their negotiated savings directly with patients.

We need as many people possible to sign in ‘PRO’ before NEXT WEDNESDAY 2/1. It only takes 30 seconds!

➡️ Senate sign in HERE!

➡️ House sign in HERE!

Share the Savings

Health care is, unfortunately, a complicated system in the United States, with numerous players involved at every step. While the manufacturer makes the drug, the PBM contracts with the health insurance carriers to manage their prescription drug programs. PBMs are essentially the middlemen who negotiate rebates for the cost of prescription drugs and place medications within each health plan’s drug formulary. On average, manufacturers rebate 40% of a medication’s list price back to insurers or PBMs.

However, these rebates are really intended to be passed on to patients, which is particularly necessary for patients with health plans that utilize high deductibles or significant cost sharing. These patients are charged the full list price at the pharmacy counter, not the after-rebate price. PBMs and insurers pocket the savings from these rebates, while patients rarely see their fair share.

Share the Savings would fix that loophole by requiring 100% of rebates to be shared directly with patients – meaning patients see immediate savings at the pharmacy counter. Access to these rebates will help ensure patient adherence to their prescribed medications, as patients will often ration or stop medications if the over-the-counter costs are prohibitive. Share the Savings is one step that can help prevent patients from having to make that choice.

Drug manufacturers, health insurance companies and PBMs all play a part in delivering necessary medications to patients. The legislature has done much over the past few years to address the manufacturer’s role in drug pricing. Share the Savings ensures that we address other parts of the prescription drug supply chain that currently prevent savings from reaching the patients most in need of these rebates.

The WRA aim to expand access to healthcare and most importantly, improve the lives of the patients we treat. Share the Savings is one way to ensure Washingtonians can afford the lifesaving medications they need. We look forward to continuing this work to help all Washingtonians access innovative, affordable medicines.

Please don’t hesitate to reach out to learn more ways to engage on this effort!

CSRO Action Alert

Earlier this year, Congressman Ami Bera, MD (D-CA-07) and Congressman Larry Bucshon, MD (R-IN-08) introduced legislation to provide relief for the large Medicare Physician Fee Schedule reimbursement cuts that are currently set to take effect on January 1, 2023.

This legislation, Supporting Medicare Providers Act of 2022 (H.R. 8800), would provide a one-year “hold harmless” payment to offset the looming reductions in the Fee Schedule. The bill also establishes a “Sense of the Congress” that the Department of Health and Human Services and the Congress should commit to:

  1. ensuring financial stability and predictability in the Medicare physician payment system;
  2. promoting and rewarding value-based care innovation; and
  3. safeguarding timely access to high-quality care by advancing health equity and reducing disparities.

H.R. 8800 already has over 80 bipartisan cosponsors, but your support is needed to urge Congress to act on this bill.

Visit the CSRO Action Center to convey your support TODAY. With just a few keystrokes, you can send our template message to your representatives and make a lasting impact.


Thank you for getting involved!

Take Action Now

Join us for the Arthritis Foundation Bone Bash

The Washington Rheumatology Alliance is Honored to Sponsor the 14th Annual Bone Bash!

October 22nd, 2022

6:30 PM- 10:00 PM

Brightwater Environmental Education and Community Center

22505 State Route 9 SE

Woodinville WA, 98072-6010


The Arthritis Foundation Great West Bone Bash is one of Seattle’s most cherished traditions and one of the hottest Halloween themed fundraisers in town. The evening features amazing costumes, frighteningly fabulous food stations throughout the night, wine, dancing, and jaw-dropping silent and live auction items.

Bone Bash brings the community together to raise awareness of the prevalence and seriousness of arthritis, as well as raise funds to support mission driven programs. Funds raised support research to find a cure, provide funding for our local Juvenile Arthritis KAT-Fish Family Camp and our free community education programs.

Purchase your tickets today:


Support the Arthritis Foundation by making a donation here:

Support the Cause

For more information or to inquire about sponsorship opportunities and auction donations please contact Michal W. Wiesbrock at or call 805-295-8891.

Office of Inspector General: MAOs & Pre Authorization Requests

April 2022: Some Medicare Advantage Organization Denials of Prior Authorization Requests Raise Concerns About Beneficiary Access to Medically Necessary Care

With there being the potential concern of MAOs having the ability to increase profits by denying payments and access to services to providers, the OIG conducted this review from a random sample of 250 denials of prior authorization requests and 250 payment denials issued by 15 of the largest MAOs during the month of June 2019.

Report in Brief 

Introducing Our Stories Rx

As an initial convening, Our Stories Rx is hosting a virtual roundtable conversation with Antonio Ciaccia, who served as the government affairs director for the Ohio Pharmacists Association in 2018, when a state audit revealed a PBM-led spread pricing scheme that overcharged the state Medicaid agency by over $200m.

Our Stories Rx invites you to a virtual roundtable with Antonio Ciaccia, President of 3 Axis Advisors and CEO of 46brooklyn Research, for a discussion on Pharmacy Benefit Managers and his experience unwinding the web of cost and access issues associated with PBM interactions between clinical providers, state Medicaid agencies, and patients across the US. The discussion will be moderated by Karen Ferguson, Practice Administrator at Arthritis Northwest, PLLC. This event will occur on Wednesday, 6/30, from 12p – 1p PST. Register by clicking here.

About Antonio Ciaccia:
Born and raised in pharmacy, Antonio has been involved with pharmacies his entire life.  After three years as a pharmacy technician and two years of pre-pharmacy curriculum, Antonio diverted course, graduating from The Ohio State University in 2007 with dual degrees in communications and political science before moving into the world of association management. Thinking that pharmacy would be in his rear-view mirror forever, he ended up making his way back to his pharmacy home, heading up government affairs for the Ohio Pharmacists Association.

After years of studying the pharmacy marketplace, Antonio became increasingly perplexed and concerned as he saw drug costs spiking while payouts to pharmacies were declining. Knowing something was being lost somewhere in the middle of an ever-growing transaction, Antonio has spent years working to crack the drug pricing code and pull the rug out from what he believes is one of the most dysfunctional marketplaces in the world.

About Karen Ferguson:
Karen Ferguson is the Practice Administrator at Arthritis Northwest, PLLC, the largest clinical rheumatology practice Northwest of Denver, and headquartered in Spokane, Washington. Karen founded Our Stories Rx, and is also the co-founder and CEO of Discus Analytics, Inc., a healthcare IT company addressing the unmet need for organized, discrete, and clinically actionable information supporting the physician and patient’s longitudinal journey together.

As Practice Administrator for Arthritis Northwest, Karen led her organization to earn the national recognition for quality care, “NCQA Patient-Centered Specialty Practice Recognition” which distinguishes practices that communicate, collaborate, and integrate care in ways that demonstrates constant improvement through communication, coordination, and providing access to care.

Ms. Ferguson is past President of the Washington State Medical Group Management Association and the Inland Empire Medical Group Managers Association. She currently serves as ARP/ACR Education Committee, NORM Payer Committee, and CSRO Payer Committee.  Ms. Ferguson received her Master of Science in Health Education/Promotion from Whitworth College, and a Bachelor of Science degree in Physical Education from San Diego State University.

About Our Stories Rx:
Our Stories Rx is a 501(c)4 organization focused on developing an interactive storytelling platform that will advocate for policy outcomes that improve the health and well-being of vulnerable patient populations and the community clinics that serve them. By documenting and publicizing the experiences of patients, clinical providers, and other purchasers of healthcare services, Our Stories Rx seeks to build qualitative and quantitative tools to advance a data-driven, community centered platform with a proactive vision for advocacy and policy reform.

New Medicare Changes

We are providing information that hopefully will help our members understand the 2021 Final WRVU billing codes and reimbursements slated for Rheumatologists.

  1. The final WRVU code values for E & M coding: Please notice that at the end of 2020, the WRVU was set at a lower number, and increased to 34.89 early 2021. Because 34.89 represents the universal conversion factor, it needs to be budget neutral, so you will see other specialties actually have decreased over all. Because the E & M codes are newly defined, rheumatologists actually are increased by approximately 13%.
  2. A cheat sheet for rheumatologists to understand both the E & M coding requirements as well as the time based coding, which includes time spent face-to-face as well as activities that a physician does in review, reporting, dictation, or preparation to see the patient, on the date of service.
  3. Final Medicare Ruling: Add on codes G2211 on hold until 2024, however can still be assigned a PFS payment STATUS INDICATOR of B (bundled) until 2024.

Genentech Stance on Most Favored Nations (MFN) Model

On December 15, 2020, Genentech led a discussion about how the Most Favored Nations (MFN) model threatens provider and patient access to existing and future medicines; we share your concerns that this could have a detrimental impact on your practice and ability to treat patients. Genentech agrees that we have to work together across the healthcare delivery system to enable all Americans to receive appropriate and affordable care. As we do this, we must protect and sustain patient access to scientific innovation in the U.S. so that people with serious diseases continue to benefit from the breakthrough medicines they depend on. Never has this need been clearer than during the current COVID-19 pandemic.

Below is more information on the MFN model, Genentech’s position, as well as that of other organizations.

If you would like to independently advocate against this model, I suggest that you reach out to your physician specialty societies and ask them to:

  • Engage policymakers, in Congress and in the current and incoming administrations, to stop the implementation of MFN;
  • Communicate their concern to CMS via written comments; and
  • Consider joining or pursuing litigation challenging implementation of MFN. The most expedient way to get societies involved in existing cases is for them to contact representatives at PhRMA ( or BIO (

Additionally, you can reach out to your federal and state representatives, to request that they weigh in opposing the model with their peers, and existing and incoming administration officials.

Downloadable Resources from the Arthritis Foundation

The Arthritis Foundation has free downloadable brochures and fact sheets through the AF Store​ that you can save to your office desktop. The brochures and fact sheets can be e-mailed to patients or you can print copies in-office and hand out to patients as needed. The downloadable materials are a convenient way to provide your patients, who may not be comfortable taking printed materials from your office as a result of the Covid-19 pandemic, the information they are looking for. Instructions are available here.

If you are in need of a bulk order of printed brochures or fact sheets, please contact your local Arthritis Foundation staff member at for assistance.

The Arthritis Foundation also created a Covid-19 Resources flyer that has a list of great patient resources to help them navigate the pandemic and stay connected.

Biosimilars Could Generate $100 Billion in Savings Over Next Five Years, New Report Finds

WASHINGTON, D.C. — A new report from the IQVIA Institute for Human Data Science has determined that biosimilars are on track to reduce drug costs by $100 billion over the next five years if their use rises. The future of this lower-cost drug market, however, is still uncertain.

According to the report, three recently-launched biosimilars may reach 60 percent volume share by the end of their second year on the market, which would generate an estimated $80 billion in savings in the next five years, including $16-36 billion in 2024 alone. Click here to read the full article.

The Biosimilars Forum is a nonprofit organization incorporated in Washington, DC, created to advance biosimilars in the United States with the intent of expanding access and availability of biological medicines, and improving health care. The Biosimilars Forum provides evidence-based information to inform and support public policies that encourage awareness, access, and adoption of biosimilars.