Over 50 Healthcare Groups Raise Concerns to the Administration Over Pharmaceutical Tariffs

CSRO joined 52 provider and patient advocacy groups in sending a letter to the U.S. Department of Commerce Secretary, Howard Lutnick, and U.S. Trade Representative (USTR) Ambassador Jamieson Greer detailing concerns about potential Section 232 tariffs on medicines and pharmaceutical ingredients. The groups underscored how more than half of active pharmaceutical ingredients used in Americans’ prescriptions come from Europe and India and do not pose a security threat. Therefore, CSRO and the other organizations urged the Administration to exempt Europe and allied nations, such as India, from the proposed 15 percent tariff. This exemption is crucial to prevent disruptions in the U.S. drug supply chain, which could lead to increased drug costs and decreased patient access to medications.

CSRO and Healthcare Organizations Urge the Department of Labor to Enhance Regulation of Pharmacy Benefit Managers

On August 26, CSRO joined a coalition of organizations in a letter led by the National Consumers League, urging U.S. Department of Labor Secretary Keith Sonderling to enhance oversight of pharmacy benefit manager (PBM) arrangements with payers. The letter highlighted the urgent need for increased transparency regarding how PBMs are generating record-breaking profits through vertical integration within the healthcare supply chain. CSRO and the other signatories presented several reform recommendations, which include banning spread pricing, delinking rebate pass-throughs, and implementing stronger transparency requirements for PBM revenue sources. Through this advocacy effort, CSRO continues to collaborate with a diverse coalition of stakeholders to address PBM abuses and promote policies that protect both patients and healthcare providers.

Legislation Around the Country

CSRO Leadership Continues to Voice Concerns over Colorado and Oregon PDABs' Pursuit of Upper Payment Limits  

CSRO continues to lead and collaborate with coalition partners to raise concerns about state Prescription Drug Affordability Boards’ (PDABs) approach to establishing upper payment limits (UPLs). CSRO board member Harry Gewanter, MD, submitted written testimony on behalf of the Let My Doctors Decide Action Network and spoke to Bloomberg prior to Colorado’s third rulemaking hearing regarding the proposed UPL for Enbrel. In his remarks, Dr. Gewanter highlighted that the PDAB has not provided evidence that the proposed UPL would reduce patient drug costs or expand access to essential medications. He also urged the Board to engage more thoroughly with insurers and pharmacy benefit managers (PBMs), as previously promised, to clarify how any finalized UPL would be implemented and to ensure that appropriate safeguards are in place. Furthermore, Dr. Gewanter submitted testimony to the Oregon PDAB expressing similar concerns as the Board begins affordability reviews on a wide range of therapies. His statements reiterated that there is limited evidence suggesting that UPLs enhance patient access or affordability, emphasizing the need for careful evaluation of the potential unintended consequences for both providers and patients.

Dr. Feldman Arms Patient Advocates with Strategies to Fight Copay Accumulators, Maximizers, and Alternative Funding Programs at Healthcare Advocate Summit

Madelaine Feldman, MD, FACR, CSRO, Vice President of Advocacy and Government Affairs, was invited to provide the physician perspective during a panel discussion at the annual Healthcare Advocate Summit on September 3, 2025, in Las Vegas. Dr. Feldman joined leading advocates from the PAN Foundation, the Bleeding and Clotting Disorders Institute, and CancerCare for a lively session titled Helping Patients Navigate and Advocate Against Copay Accumulators, Maximizers, and Alternative Funding Programs. She served as a critical thought leader on the panel, educating attendees on the key differences between copay accumulators, maximizers, and alternative funding programs. During the discussion, Dr. Feldman highlighted the ongoing challenges these insurance practices pose to patients and rheumatology practices and shared advocacy strategies to combat them effectively. Her participation underscored CSRO’s continued partnership with patient advocacy groups to lead state and federal advocacy efforts against harmful insurance programs.

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.

CA

• Prior Authorization (AB512): Read second time. Ordered to third reading.
• Rebate Pass Through | PBM Reform (SB41): Read second time. Ordered to third reading.

DE

• Prior Authorization (SB12): Sent to Governor

MA

• Biomarker Testing Coverage (HB1227): Hearing rescheduled to 04/29/2025 from 10:00 AM-01:00 PM in A-2 and Virtual Hearing updated to New End Time
• Biomarker Testing Coverage (SB809): Hearing rescheduled to 04/29/2025 from 10:00 AM-01:00 PM in A-2 and Virtual Hearing updated to New End Time
• Copay Accumulator Adjustment Program Ban (HB1101): Hearing rescheduled to 04/29/2025 from 10:00 AM-01:00 PM in A-2 and Virtual Hearing updated to New End Time
• Copay Accumulator Adjustment Program Ban (SB698): Hearing rescheduled to 04/29/2025 from 10:00 AM-01:00 PM in A-2 and Virtual Hearing updated to New End Time

WI

• 340B Drug Pricing Program | Copay Accumulator Adjustment Program Ban | PBM Reform | Step Therapy (AB173): Representative Palmeri added as a coauthor
• Copay Accumulator Adjustment Program Ban | Non-Medical Switching | Maximizer Program Ban (SB203): Representative Palmeri added as a cosponsor



Advocacy Conference: September 12-13, 2025

Join CSRO in Dallas, Texas, for our annual Advocacy Conference! 

Virtual Advocacy Day: October 8, 2025

Save the date to advocate alongside CSRO as we host live conversations with health care leaders. Be notified when registration launches by clicking here!

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.

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.

Advocacy Council

Amplify your voice by assembling with other like-minded individuals to enhance CSRO’s advocacy initiatives.

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.