From the Nation’s Capital

CSRO Calls for Broader Drug Affordability Solutions for Patients in Response to Wyden RFI

In August, CSRO submitted comments to Senate Finance Committee Ranking Member Ron Wyden in response to his Request for Information (RFI), Commonsense Policy Options to Lower Drug Prices for Patients, which builds on the Senate Democratic Caucus's work on drug affordability since the enactment of the Inflation Reduction Act. CSRO urged lawmakers to evaluate affordability holistically, weighing whether the root cause lies in drug price or other factors such as benefit design or failure to pass rebates through to patients.

In its comments, CSRO warned that the Most Favored Nation (MFN) model would restrict patients' access to essential medications while threatening the viability of private practices, since rheumatology's "buy and bill" model cannot absorb the proposed reimbursement cuts. CSRO also urged lawmakers to consider the bigger picture on biosimilar development and adoption, noting that uptake has been slower than expected due to "underwater" reimbursement for many physician-administered biosimilars. To address this, CSRO proposed that lawmakers work with CMS to reform step therapy policies and establish a formulary adequacy standard, so patients can access an alternative therapy when a given biosimilar is underwater. CSRO also encouraged Congress to ban copay accumulator adjustment programs and to tackle vertical integration by the largest pharmacy benefit managers (PBMs) and their healthcare parent companies as additional legislative solutions to address drug affordability for patients.

Time to Fix Medicare's Broken Physician Payment System: CSRO Weighs in with House Doctors Caucus

Over the past year, CSRO has regularly engaged with the House Doctors Caucus on long-term proposals to fix the Medicare Physician Payment System. This summer, the Caucus released a Request for Information seeking feedback on fiscally responsible ways to deliver a sustainable, inflation-based Medicare payment update. CSRO provided feedback to the Caucus by offering legislative “pay for” solutions, as requested, to help offset the cost to taxpayers of adopting a new Medicare physician payment system adjusted for inflation. The healthcare cost-saving opportunities CSRO shared with the Caucus were PBM reforms that tackle vertical integration and prevent inappropriate Medicare Advantage "upcoding” practices by payers. Specifically, the Coalition called on Congress to pass the No UPCODE Act to combat rampant Medicare Advantage fraud—a measure the CBO estimates could save taxpayers $124 billion over ten years and improve Medicare solvency.

CSRO Responds to HELP Committee's 340B Discussion Draft, Calls for Greater Oversight and Transparency

CSRO provided written feedback on August 18 to the U.S. Senate Health, Education, Labor, and Pensions (HELP) Committee in response to Chairman Bill Cassidy, MD's (R-LA) request for feedback on the 340B Drug Pricing Integrity and Affordability for Patients Act Discussion Draft. One central argument CSRO made to the Committee was that the 340B Drug Pricing Program has strayed drastically from its original mission of ensuring that underserved, low-income, and uninsured patients receive the medications they need at little to no cost.

CSRO called on Congress to define a 340B-eligible patient beyond simply the patient's relationship with the covered entity and expressed appreciation that the Senate HELP Committee's discussion draft offers a broader patient definition that incorporates timelines for care. The comments also urged lawmakers to impose stricter limits on contract pharmacies and bring greater transparency and oversight to the program.

Across the States

VA: CSRO and Coalition Partners Strategize to Advance Biomarker Testing Legislation in 2027

For years, CSRO has partnered with the American Cancer Society Cancer Action Network (ACS CAN) and other healthcare organizations on a national campaign urging states to enact comprehensive biomarker testing coverage. Last month, the coalition turned its focus to Virginia, one of its target states for the 2027 legislative session. It started developing a strategy to introduce and advance biomarker testing legislation there. CSRO Board member Harry Gewanter, MD, FAAP, MACR, represented CSRO at a coalition meeting, serving as CSRO's on-the-ground voice and offering insight as the group discussed how best to navigate political dynamics, close payer coverage gaps in the state, and gather patient stories to support the forthcoming legislation. Currently, 25 states have comprehensive biomarker testing laws, and Delaware is poised to become the 26th after its legislature passed a bill earlier this summer.

What's Happening in the States

Interested in learning more about CSRO’s engagement in the states? Visit our State Legislation Correspondence page to review the letters submitted to state legislatures on CSRO’s priority issues.

Click above to access CSRO’s new State Legislative Tracker to find the status of CSRO’s priority legislation affecting the rheumatology community and its patients at the state level.

Business of Rheumatology Seminar Series - Building a Clinical Research Program in Community Rheumatology Practice: September 16, 2026

Join us for the September Business of Rheumatology webinar as we discuss how practices can successfully engage in clinical research to improve patient care and support practice growth. This session is part of our ongoing webinar series, with support from Johnson & Johnson.

Register here!

Advocacy Conference: October 2-3, 2026

Join us in Washington, D.C. for CSRO’s flagship Advocacy Conference to learn, network, and strategize around patient access to care. Register here.

Business of Rheumatology Seminar Series - Smart Payer Contracting and Transparency in Coverage: December 2, 2026

Join us for our December Business of Rheumatology webinar to learn how to navigate payer contract negotiations with confidence. This session is part of our ongoing webinar series, generously supported by Johnson & Johnson.

Register here!

Fellows Conference: March 19-20, 2027

Calling all rheumatology fellows! Mark your calendars to join us in San Antonio, TX , for the CSRO annual Fellows Conference.

Sign up for the Registration Launch here!

2027 Advocacy Conference: September 10-11, 2027

Save the date for our 2027 Advocacy Conference, held in Washington, D.C.!

State Society Conferences:

CSRO's state rheumatology society members host their own annual meetings throughout the year. Find a listing of these state-specific conferences on our website.

Action Center

Use CSRO's convenient online platform to easily find out who your elected officials are and engage with them directly.

Career Center

Locate the perfect fit whether you're looking for new career opportunities or trying to find the right candidate.

Explanatory Statement: “Underwater” Biosimilars

To aid in addressing the issue of "underwater" biosimilars with payers, CSRO has created a document to illustrate the extent of the problem.

Legislative Map Tool

Find your state on our interactive map tool to learn about current or proposed policy and ways you can take action to make an impact.

Payer Issues Reporting Form

Request assistance with any payer relation issues that may be impacting your patients or office.

Policy Correspondence

Easily access all of CSRO’s policy letters submitted to payers, state, and federal governments as an informational resource.

Rheum for Action

Learn about the latest advocacy issues in CSRO's advocacy column authored by Dr. Madelaine Feldman and produced in partnership with Medscape.

Step Therapy Cover Sheets

Review CSRO's state-specific step therapy materials that help guide practices in gaining an exemption from step therapy protocols.

Questions?

Please visit the CSRO website for other news and updates, and do not hesitate to contact us with any questions at info@csro.info.