Regence Policy Reversed: The decision from Regence to mandate the switch from Rituxan patients to Ruxience has been reversed and Regence will approve Rituxan patients currently on treatment to continue for 1 year. If you have already submitted the authorization for the patients, then just re-submit their name, DOB and member # via fax to your pharmacy dept. If you haven’t yet submitted an auth, then please submit auth as you normally would.
The pieces that were challenged by Arthritis Northwest Regence’s policy with were:
- The article (download and keep for your files) clearly stating that biosimilars can be substituted only if approved by FDA as “interchangeable.” In addition, substitution can only be allowed if the prescriber has not designated on the prescription that substitution is prohibited.
- The concern that my physicians felt regarding “Switching” a stable patient to a non FDA indicated treatment when there are other alternative biosimilars on the market that are indicated for RA.
- The Washington State Step Therapy Legislation #1879 which clearly outlines the exemption process for immediately granting the request if patient is stable and doing well on treatment.
This is a major “win” in keeping our physicians at the forefront of healthcare. Allowing physicians who are in the position for making the right decision of treatment for the best clinical outcome and accountability for total cost of care, always delivers the best possible patient centered care.
Dear colleagues and industry representatives,
After much trepidation and thought I’ve decided to cancel this year’s WRA annual conference. Response from our survey suggested that turn out would have been about half normal and our sponsors were nervous given the continued coronavirus activity. I just couldn’t guarantee everyone’s safety. Our speakers and our sponsors have been notified and they have agreed to wait until next year. All of the funding that has been put forth to this meeting will be rolled over to next year, too. As always, I look forward to seeing everyone at the WRA meeting in Leavenworth next year. Please save the date for September 17-19, 2021.
Thank you for your continued support,
Jeff Peterson, MD
Patients with interstitial lung disease demonstrated a higher proportion of comorbidities and rheumatoid arthritis activity, as well as rheumatoid arthritis-related conditions, according to a presenter at the EULAR 2020 Virtual Congress.
“Interstitial lung disease is a common extra-articular manifestation of RA, and is known to be associated with increased morbidity and mortality,” Gary Craig, MD, of Discus Analytics and Arthritis Northwest, both in Spokane, Washington, told attendees in the session. “Studies have shown substantial variability in the prevalence, clinical characteristics and risk factors of RA-associated ILD, or RA-ILD.” Click here to read the full article.
UnitedHealthcare is working to help people access health care to the fullest extent possible as we come together to address this national emergency. We’re adopting measures that will reduce administrative burden for physicians and facilities, helping members more easily access the care they need under their benefit plan, and adjusting programs and services, as needed, to protect members and help limit the spread of the COVID-19 virus in communities. Visit their page for regular updates: https://www.uhcprovider.com/en/resource-library/news/Novel-Coronavirus-COVID-19/pa-covid19-updates.html
Please see the formal announcement from UHC. UnitedHealth Group (NYSE: UNH), through UnitedHealthcare and Optum, has announced it is taking steps immediately to accelerate payments and other financial support to health care providers in the U.S. to help address the short-term financial pressure caused by the COVID-19 emergency.
The decision to accelerate claims and incentive payments builds on previously adopted measures taken by the company to streamline processes for health care professionals and facilities, as well as to help members more easily access the care they need. This includes:
- Suspension of prior authorization requirements to a post-acute care setting
- Suspension of prior authorization requirements when a member transfers to a new provider
- Extension of timely filing deadlines for claims during the COVID-19 public health emergency period for Medicare Advantage, Medicaid, and Individual and Group Market health plans
- Implementation of provisional credentialing to make it easier for out-of-network care providers who are licensed independent practitioners to participate in one or more of our networks
Official press release:
The Washington State Medical Association (WSMA), Washington state officials, and the state’s health care community have joined the Centers for Disease Control and Prevention in responding to an outbreak of respiratory illness caused by a novel coronavirus (COVID-19). Initially detected in Wuhan City, Hubei Province, China in December 2019, COVID-19 is now spreading in Washington state and other U.S. locations.
WSMA has a dedicated COVID-19 resource page that features patient and professional resources: www.wsma.org/covid19.
The ACCME has compiled a list of educational resources about COVID-19 for physicians, all of which include CME credit. The education consists of online courses, video, or articles, and most of these resources are free: https://accme.org/coronavirus-resources.
CreakyJoints is a digital community for millions of arthritis patients and caregivers worldwide who seek education, support, advocacy, and patient-centered research. All of our programming and services are always provided free of charge.
- Education: Constantly updated and informed by the latest research, our educational articles and comprehensive patient guidelines help newly diagnosed and experienced patients as well as caregivers understand their diagnosis, symptoms, and traditional and complementary treatment options. We also provide advice regarding how to communicate effectively with health care providers, insurance companies, and the stakeholders who write our health laws and policies.
- Support: Through our interactive social media channels, CreakyJoints members can directly connect with the arthritis community and ask questions of health care professionals who participate in regularly scheduled webinars and #CreakyChats. Visit us on Twitter (@CreakyJoints), Facebook, YouTube, and Instagram (@Creaky_Joints) for a 24/7 hive of positive support.
- Advocacy: We believe that patients need to participate in all conversations that relate to our access to treatment, safety, or the quality of our care. Through our 50-State Network, we train and help patients living with any diagnosed, chronic illness to amplify their voice and add their personal perspective to health policy discussions happening in Washington, D.C., the state capitals, hearing rooms, regulatory meetings and other public forums. Whether adding your name to a petition, speaking in front of lawmakers, or contributing an opinion article to your local newspaper, we invite you to join our network to influence the future of health care in the United States.
- Patient-Centered Research: Created by CreakyJoints and supported by a multiyear, multi-million dollar investment by the Patient-Centered Outcomes Research Institute (PCORI) as well as additional public-private partnership support ArthritisPower is the first-ever patient-centered research registry for joint, bone, and inflammatory skin conditions. The free ArthritisPower mobile and desktop application allows patients to track and share their symptoms and treatments while also participating in voluntary research studies in a secure and accessible manner. ArthritisPower Patient Governors serve as gatekeepers for researchers who seek to access registry data or solicit the community to participate in unique, voluntary studies. Since 2016, 45 ArthritisPower studies were published in peer-reviewed journals or presented at major medical meetings as abstracts or posters, in partnership with major universities, research institutions and industry. To learn more and join ArthritisPower, visit www.ArthritisPower.org.
Discus Analytics, LLC., is a healthcare company specializing in the capture, analysis, and application of actionable clinical data, and believes that specialists who implement a data collection portal capable of tracking patient outcomes and quality metrics in real-time have a decided advantage within the changing landscape of healthcare reform.
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