Washington Rheumatology Alliance

From CreakyJoints:

We’ve been hearing many questions and concerns from our global patient community about the continued spread of coronavirus across the U.S. and around the world.

And while people with disabilities and chronic diseases have even more of a right to feel worried or downright panicked, there is a lack of good information speaking directly to these issues for patients — until now.

CreakyJoints spoke with multiple rheumatologists and infectious disease experts to try to track down answers that are as specific to this community as possible.

Here’s what we have learned so far. We will update you if critical information changes and we will continue to monitor the situation closely. Read the full article.

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The contents of this website are for informational purposes only and do not constitute medical advice. CreakyJoints.org is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition.

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:

1. 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.
2. 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.
3. 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.

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:
https://www.unitedhealthgroup.com/newsroom/2020/2020-04-07-uhg-accelerates-payments-support-providers.html