On Capitol Hill

CSRO Engages as PBM Reform Momentum Builds on Capitol Hill

The new year on Capitol Hill began with strong bipartisan support for advancing meaningful reforms to pharmacy benefit managers (PBMs). Early this month, CSRO engaged lawmakers by submitting letters in support of the PBM Transparency and Accountability Act (S.3345), a bipartisan bill from Senate Finance Committee leaders that delinks PBM compensation from the Medicare Part D program.



Momentum continued this week as several provisions from Rep. Buddy Carter’s PBM Reform Act – supported by CSRO – became part of the Consolidated Appropriations Act, 2026. The appropriations package includes CSRO-supported PBM reforms: it delinks PBM compensation under Medicare Part D, requires all commercial rebates for ERISA plans to be passed through to employers, bans Medicaid spread pricing, and strengthens PBM transparency. Before yesterday’s House vote on the funding bill, CSRO sent an Action Alert urging rheumatologists and their practice partners to contact their members of Congress to support the PBM reforms in the appropriations bill. The House passed the appropriations bill 341–88. The bill now moves on to the Senate, where CSRO will keep advocating for the passage of these reforms.

CSRO Responds to House Doctors Caucuses MACRA Modernization RFI

Last week, CSRO submitted comments in response to the House Republican and Democratic Doctors Caucuses’ Request for Information (RFI) on modernizing the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). In its comments, CSRO outlined the need for legislative reforms to Center for Medicare and Medicaid Innovation (CMMI) models, including the establishment of guardrails to ensure that rheumatologists and other providers are not held financially responsible for drug costs beyond their control. CSRO also emphasized the need to improve the Merit-based Incentive Payment System (MIPS), noting that it fails to adequately recognize high-value specialty care, such as rheumatology, and raised concerns about whether the program should be restructured or replaced, as the Caucuses inquired. Additionally, CSRO called for the development of a physician-led quality program tailored to rheumatology that reflects the complexities of managing chronic autoimmune diseases.



CSRO also joined an Alliance of Specialty Medicine coalition letter that responds to the MACRA Modernization RFI. The letter echoes similar concerns and highlights longstanding structural issues in the Medicare Physician Fee Schedule (MPFS), including the lack of inflationary updates.

Legislation Around the Country

CSRO and the All Copays Count Coalition Gain Early Traction Across the States

CSRO, with its work with the All Copays Count Coalition, joins a broad alliance of patient and provider groups advocating for legislation that bans or limits copay accumulator programs. The Coalition recently secured an early win when New Jersey Governor Phil Murphy signed A5217/SB3818 into law, following coordinated advocacy efforts, including CSRO’s urging of the Governor to immediately pass the bill. With the enactment of the New Jersey law, a total of 26 states—along with Washington, D.C., and Puerto Rico—now have laws ensuring that all patient copay assistance counts toward out-of-pocket costs.



Looking ahead, CSRO and the All Copays Count Coalition will continue their targeted advocacy in state legislatures to advance reforms on copay accumulators. Most recently, CSRO submitted written comments to the Missouri Senate Committee on Families, Seniors, and Health in support of a ban on copay accumulator programs. Missouri is expected to be a key battleground state on this issue in 2026, alongside seven other priority states where coalition-backed advocacy efforts are underway.

WA: CSRO and the Washington Rheumatology Alliance Oppose Expansion of Contract Pharmacies Participating in the 340B Program

The Washington Rheumatology Alliance (WRA) and CSRO submitted comments opposing legislation in Washington State that would expand the use of contract pharmacies within the 340B program. Both CSRO and WRA articulated their concerns to the members of the House Health Care and Wellness Committee and the Senate Health & Long-Term Care Committee and asked that the bills not be advanced at recent committee hearings over the past two weeks. The chief concerns for both HB2145 and SB 5981 were that the bills would enable greater expansion of contract pharmacies within the 340B program, without any oversight to ensure that underserved patients receive discounted medications from contract pharmacies associated with DSHs.

CSRO Map Tool: Next Gen Now Live!

We’re excited to announce the official launch of the Next Generation CSRO Map Tool! This enhanced platform delivers a more powerful, user-friendly experience to help you stay informed and engaged in state and federal advocacy efforts.

What’s New:

• Smarter Search: Filter by issue and easily see whether legislation is active or enacted.
• Expanded State Pages: Access legislative session dates, direct links to each state’s legislature website, and “find your legislator” tools—all in one place.
• Office-Ready Resources: A new printer-friendly “File a Complaint” version is now available for your practice use.
• PERT Integration: Quick access to the CSRO Prescriber Education and Resource Tool (PERT).
• Comprehensive Legal Insight: The “Know the Law” dropdown now covers all key policy issues.
• Federal Advocacy Updates: Explore CSRO’s federal priorities, with live “Take Action” links—even for critical legislation like Protecting Patient Access to Cancer and Complex Care (H.R. 4299).
• Real-Time Alerts: Additional updates will roll out as new federal actions are introduced throughout the year.

Visit the new Map Tool today to explore all the enhanced features and stay engaged in CSRO’s advocacy work.

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.

CSRO State Legislative Forecast: February 11, 2026

Kick off the year with CSRO’s virtual State Policy Update, highlighting key priorities and trends for the 2026 legislative session. Hear from our government affairs team about upcoming policies affecting private practice, reimbursement, and patient access—and how you can advocate effectively. Register 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.

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.