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SPOTLIGHT: DMARD Use in Patients with Rheumatoid Arthritis
11/27/2018 • Posted by Provider Relations

As a Medicare/Medicare-Medicaid provider, you know that quality health care is a high priority for Fidelis Care and the Centers for Medicare & Medicaid Services (CMS). CMS and the New York State Department of Health consider DMARD use an important quality measure in patients with Rheumatoid Arthritis (RA). The American College of Rheumatology recommends the addition of a DMARD to patients with RA, preferably within 3 months of disease onset. DMARDs have been shown to suppress inflammation and prevent further joint injury. The following DMARDs are on our formulary:

                                                  Non-Biologic DMARDs           Biologic DMARDs
                                                  Methotrexate tablets                 Humira*
                                                  Leflunomide                                 Xeljanz*
                                                  Hydroxychloroquine                   Xeljanz XR*
                                                  Sulfasalazine    
                                                                * Prior Authorization is required

Please consider using one of these DMARDs when treating your patients with RA.  If you have any questions, please call the Provider Call Center at 1-888-FIDELIS (1-888-343-3547).  
 

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Each day, Fidelis Care's Utilization Management (UM) Department makes decisions on numerous health insurance claims. These decisions are based only on appropriateness of care and the existence of coverage. 

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