The ACR works with the Affiliate Society Council, representing local and state rheumatology societies, and other advocacy coalitions to affect positive change at the state legislative and regulatory levels. On key issues important to the rheumatology community, ACR initiatives include policy tracking and analysis, providing comments on legislation or rules being considered, and arranging testimony at hearings by our members. See below for information on several of the current issues being tracked on the state level.
Biosimilar Substitution
The ACR supports timely notification of the prescribing physician when a biosimilar is being dispensed. This preserves the doctor/patient relationship by ensuring that the patient is getting the medication that the prescribing physician intended.
Prior Authorization
The ACR supports policies that enable physicians to choose the most appropriate treatment for the patient without the hindrance of excessive administrative processes for approval from insurers.
Specialty Tiers
Specialty tiering practices utilized by insurance carriers result in excessive patient financial burden and greatly reduced access to medically-necessary treatments.
Specialty Tiers MA SB 477
Step Therapy
The ACR opposes step therapy practices, also known as fail-first policies, step protocol, sequencing or tiering. Access to treatment should be reasonable and timely without unnecessary barriers to medically necessary care.
CT SB 394 ACR Support Letter Step Therapy Requirements
Pharmacy Benefit Managers (PBMs)
The ACR supports efforts to increase the transparency of drug pricing practices. The ACR is working in partnership with the Alliance for Transparent and Affordable Prescriptions to raise awareness of the role of PBMs in drug pricing.
Non-Medical Switching
The ACR supports efforts that would allow stable patients to remain on the prescription chosen by their physician. The ACR also supports efforts that would prevent mid-year formulary changes that could force a patient to switch medication for non-medical reasons.