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News & Advocacy

Payer Advocacy Update: CVS Caremark to Revise Prior Authorization Forms; UHC Updates “Incident-to” Policy

posted: January 3, 2022

By American College of Rheumatology

CVS Caremark to Revise Prior Authorization Forms in January 2022

In July, CVS Caremark changed its prior authorization forms for many biologic drugs, creating an increased administrative burden for rheumatology practices. Chief among the many complaints the ACR received were new criteria around the evaluation of treatment efficacy for continuation of therapy requests. ACR leaders shared these concerns with CVS Caremark and received reassurance that revised forms will be implemented in January 2022. Read more

UHC Updates Policy on Reimbursement for Incident-to Services

On Aug. 1, UnitedHealthcare implemented a new policy on Services Incident-to a Supervising Health Care Provider. This new policy addresses the ACR’s concerns regarding the payer’s Advanced Practice Healthcare Provider policy and allows for appropriate reimbursement for “incident-to” services consistent with current Medicare guidelines. Read more