On Capitol Hill

CSRO Raises Concerns with Latest ACA Marketplace Proposed Rule

On March 13, CSRO submitted comments to the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) regarding the proposed 2027 Notice of Benefit and Payment Parameters (NBPP) rule. This proposed rule outlines changes to implementation and payment parameters for the Affordable Care Act (ACA) marketplace. One of the primary concerns expressed by CSRO is that this year’s rulemaking fails once again to address copay accumulator policies, resulting in continued regulatory uncertainty for patients. This oversight is particularly concerning in light of a 2023 federal court ruling directing HHS and CMS to reinforce the 2020 Notice of Benefit and Payment Parameters, which explicitly prohibited copay accumulator programs. CSRO urged these agencies to prioritize patient welfare by ensuring that all copay assistance amounts are counted towards patients' annual cost-sharing requirements.

The Coalition also expressed serious apprehensions about the proposal to expand access to catastrophic plans amidst a distressing trend of employers terminating workers with high medical costs and subsequently rehiring them as independent contractors, effectively pushing them into the individual market. CSRO called on the Administration to conduct a comprehensive review of this broader issue across multiple agencies before finalizing a rule that broadens catastrophic plan design and enrollment. Finally, CSRO outlined concerns that the proposed defrayal for state-mandated benefits for qualified health plan (QHP) enrollees may create an incentive for states to eliminate their state-mandated benefits, such as biomarker testing, to avoid the financial burden.

Legislation Around the Country

MS: Biomarker Testing Coverage Signed into Law with CSRO’s Support

On Monday, Governor Tate Reeves signed legislation into law requiring state-regulated health plans and Medicaid to cover biomarker testing. Known as “Jill’s Law,” the measure honors the late wife of Mississippi State Representative Casey Eure, who passed away from cancer last year.

CSRO supported this effort alongside a broad coalition of patient and provider organizations led by ACS CAN. After months of coalition advocacy efforts, CSRO joined a final sign-on letter to Governor Reeves, urging him to sign the bill into law. CSRO also launched a grassroots campaign encouraging Mississippi rheumatologists and practice partners to call on the Governor to pass the bill to remove barriers to biomarker testing and expand patient access to precision medicine. With the enactment of this law, Mississippi becomes the 23rd state to adopt comprehensive biomarker testing coverage requirements.

UT: CSRO Urges Governor to Sign Prior Authorization Reform into Law

Last week, CSRO submitted comments to Utah Governor Spencer Cox, urging him to pass prior authorization reform legislation that the Coalition has been working on throughout the session. The legislation would streamline the prior authorization process by imposing maximum response times for utilizing review entities and health plans to respond to requests. Additionally, it would ensure that prior authorizations remain valid for at least 12 months of treatment for chronic conditions. CSRO activated a grassroots campaign for the CSRO community in Utah to also call on the Governor to pass this critical legislation that would remove unnecessary burdens on rheumatology practices from prior authorization.

WA: CSRO Leads Full-Scale Opposition to 340B Contract Pharmacy Expansion Bill

CSRO has remained actively engaged throughout the legislative process, opposing legislation that would lead to greater expansion of contract pharmacies in Washington. The Coalition executed a comprehensive advocacy strategy to push back against this measure, including elevating the voice of Washington native and CSRO Board Director Amish Dave, MD, through an Op-Ed outlining how the expansion of the 340B drug program contributes to rising healthcare costs for patients. Dr. Dave’s Op-ed gained national visibility and was published by The Center Square, Yahoo! News, and AOL.

In addition, CSRO submitted comments to Governor Bob Ferguson urging a veto of the legislation, emphasizing the absence of meaningful guardrails to ensure that expanded 340B contract pharmacies would actually improve access to discounted medications for Washington’s low-income and vulnerable patients. The Coalition also launched a grassroots campaign statewide, urging rheumatologists and their practice partners to contact the Governor to oppose the bill. CSRO underscored that the legislation could further accelerate consolidation in healthcare by making independent rheumatology practices more vulnerable to acquisition by large 340B hospital systems.

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 Webinar: April 15, 2026

Join us virtually to gain practical insights into today’s biosimilar market and learn how to navigate these changes with confidence. Participants will walk away with strategies to choose biosimilars intentionally, protect practice margins, and improve patient access—while adapting to the evolving reimbursement environment. 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. 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.