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The American College of Rheumatology is fighting on multiple policy fronts — from proposed Medicare payment cuts to steep H-1B visa fees and political interference in NIH grant-making. Leading a coalition of 23 rheumatology groups, the ACR warned that these changes threaten patient access, physician workforce stability, and independent scientific research. The stakes are high for a specialty already stretched thin.
The American College of Rheumatology (ACR) has been on a policy blitz, pushing back against three major threats to the specialty in just one week. On Sept. 21, the ACR led a coalition of 23 rheumatology groups in urging Congress to reject a CMS proposal that would slash payments by 50% when evaluation and management (E/M) services are provided on the same day as certain procedures. The coalition argued the cut is redundant — existing rules already account for service overlap — and could force patients to make unnecessary return visits.
Days later, the ACR called on the Department of Homeland Security to exempt physicians, residents, fellows, and researchers from a proposed $103,265 H-1B visa petition fee. With nearly 26% of U.S. physicians being international medical graduates and a projected shortfall of 200,000 physicians by 2036, the ACR warned the fee would devastate non-profits and independent practices that can't absorb the cost. The ACR also applauded the Trump administration for walking back plans to give political appointees oversight of NIH peer-review grant decisions.
Key Takeaways:
Why it matters: Rheumatology practices — many already operating on razor-thin margins — face a convergence of financial and workforce pressures. The ACR's advocacy highlights how policy decisions made far from the clinic can have direct consequences for patient access and care quality.
