On Capitol Hill

CSRO-Led Coalition Urges CMS to Act on the SAD Exclusion List

CSRO continues to press for reform of the Medicare Self-Administered Drug (SAD) Exclusion List, which excludes Part B coverage for drugs deemed “usually self-administered by the patient.” Last week, CSRO and its coalition partners sent a letter to CMS Administrator Mehmet Oz, urging the agency to use the CY 2027 Medicare Physician Fee Schedule (PFS) rulemaking to address barriers created by current SAD List policies. Specifically, the patient and provider groups are asking CMS to update its SAD List criteria and establish an exception allowing Part B coverage when self-administration is not clinically appropriate or feasible. The proposal includes clear program integrity safeguards, such as documentation requirements and a claims-based modifier to confirm medical necessity.

Legislation Around the Country

CSRO Hosts 2026 State Legislative Forecast Town Hall

On February 11, 2026, CSRO held its annual State Legislative Forecast Town Hall. The event featured an update from its state government affairs team to more than 45 attendees from the rheumatology community, highlighting key policy trends and legislation to watch as state legislative sessions begin. The virtual presentation focused on three main policy areas: the 340B Drug Discount Program, Copay Accumulator Adjustment Program Bans, and Pharmacy Benefit Manager (PBM) reform, and highlighted CSRO’s other state priorities. The Town Hall emphasized the importance of the state advocacy process and offered insight on how state rheumatology organizations and their members can get involved. Attendees had the opportunity to engage with CSRO’s government affairs team, asking about effective advocacy strategies to connect with their state lawmakers and inquiries regarding pending policies that could impact rheumatology practices and patients. You can watch the Town Hall recording here.

VA: CSRO Continues to Sound Alarm about 340B Drug Pricing Program Expansion Bill

CSRO submitted comments opposing SB 278, legislation heard by the Senate Education and Health Committee. The Coalition is against this bill because it would lead to a greater expansion of contract pharmacies within the 340B program, without sufficient oversight to ensure that underserved patients actually receive discounted medications from the contract pharmacies associated with disproportionate share hospitals (DSHs). This proposal is concerning because increasing access to contract pharmacies does not solve patients’ issues with obtaining access to 340B medications. The provisions in SB 278 would only allow large pharmacy benefit managers (PBMs) to continue profiting from the existing flaws in the 340B system. For these reasons, CSRO urged Virginia lawmakers to oppose this bill and prioritize patients, enhancing accountability and transparency in the 340B system.

WI: CSRO Pledges Support for Bill Banning Copay Accumulator Adjustment Programs

Before the Wisconsin legislature adjourned, the Wisconsin Assembly Committee on Health, Aging, and Long-Term Care held a hearing on AB 173, legislation that would ban copay accumulator adjustment programs to protect patients. In Wisconsin, approximately 86% of health plans include a co-pay accumulator adjustment program – highlighting the urgent need for reform in the state. The Senate version of the bill, SB 203, passed out of the Senate Health Committee in August and was awaiting Floor action. CSRO, alongside other members of the All Copays Count Coalition, submitted written testimony in strong support of this measure in a last-ditch effort to advance the measure before lawmakers went home. Despite strong testimony from the provider and patient advocacy community, the measure did not secure passage.

What's Happening in the States

CSRO tracks legislative activity relevant to the rheumatology community and their patients. Check out the list below to see the status of CSRO priority bills from the past two weeks, and click here to view a full status report of CSRO priority bills.

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.

Fellows Conference: March 6-7, 2026

Calling all rheumatology fellows! Mark your calendars to join us in New Orleans, Louisiana, for CSRO's annual Fellows Conference.

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. Sign up for the Registration Launch here!

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.