Updates from Captiol Hill
Improving Seniors' Timely Access to Care Act
On July 27, the House Ways and Means Committee marked up The Improving Seniors’ Timely Access to Care Act (H.R.8487), which is a bill supported by CSRO and many other medical provider and patient groups. The legislation would reform the prior authorization (PA) process in Medicare Advantage plans by, among other things, establishing an electronic process for PA, reducing the use of PA for routinely approved services, and ensuring that PA requests are reviewed by qualified medical professionals.

Members of the Ways and Means Committee on both sides of the aisle spoke in strong support of the legislation and the bill was approved without amendment. This clears one major hurdle on the way to consideration by the full House, and CSRO will keep you updated on the progress.
CMS Addresses 340B in Recent OPPS Rule
As part of its annual payment rule for hospital outpatient departments, CMS included provisions addressing 340B drugs in this setting. Since the Supreme Court issued its opinion in American Hospital Association v. Becerra on June 15, CMS did not have time to make the needed adjustments in time for this proposed OPPS. Thus, the proposed OPPS reflects a continuation of existing 340B payment policy, which is reimbursement at ASP minus 22.5% for 340B-acquired drugs (with some exceptions).

However, CMS states that it fully plans to return to ASP+6% reimbursement for 340B-acquired drugs in 2023. The estimated difference between these two reimbursement levels amounts to $1.96 billion in OPPS payments. This would result in a budget neutrality adjustment of 0.9596 to the OPPS conversion factor, for a revised conversion factor of $83.279. With regard to the years 2018-2022, CMS is considering the difficult question of how to craft a remedy, since the Supreme Court did not address that issue.
Step Therapy Reform: SAIM Annual Meeting
For the past year, CSRO has served as the chair of the State Access to Innovative Medicines (SAIM) Coalition, which is the primary organizing vehicle for patient and provider advocacy organizations on the issues of step therapy and standard benefit design reform in the states.

Working through the coalition, CSRO has successfully led the passage of step therapy legislation in Arkansas, Arizona, Kentucky, and Louisiana, and at SAIM's annual meeting on July 26, target states for 2023 were tentatively identified. CSRO looks forward to partnering with our state society members on reforms in the 2023 session!
Advocacy Success - Safe Step Act Day of Action
Earlier this month, CSRO invited you to join us for the Safe Step Act Day of Action, which was designed to generate buzz amongst Congress to highlight the importance of the Safe Step Act (S.464 & H.R. 2163), federal legislation that would extend step therapy reform protections to plans that states are unable to regulate.

Overall, the day was a great success: together, we sent 54 direct messages to representatives and generated over 220 Twitter posts with 1,000 interactions, 1 million impressions, and 900 likes. This type of advocacy helps keep legislation top of mind and demonstrates to leadership the importance of advancing legislation like the Safe Step Act.

There is still time to take action! If you haven't already done so, visit the CSRO Action Center – with just a few keystrokes, you can send our template message to encourage your representatives to support this important legislation.
SSAC: Register Today to Ensure Hotel Room Availability
CSRO is dedicated to empowering the rheumatology community with resources to proactively increase patient access to care and we invite you to join us this September to learn, network, and strategize at our flagship State Society Advocacy Conference!

Our program will center on advocacy that addresses current issues impacting patients and practices, including a keynote presentation from Damon Tweedy, MD, author of the New York Times bestseller Black Man in a White Coat: A Doctor's Reflection on Race and Medicine. Learn more about our agenda and other event details on our website.

The room block is filling fast sign up today to ensure hotel room availability.
September 9-10
The Westin O'Hare
Rosemont, IL
Registration is complimentary
Rheum for ActionSpotlight on CSRO Advocacy with MACs and CMS
As we await direction from CMS regarding complex vs therapeutic drug administration coding, CSRO President Dr. Madelaine Feldman explains the issue with the Medicare policies and the steps CSRO is taking to find a solution.

Read more in the latest edition of Rheum for Action, CSRO's advocacy column produced in partnership with Rheumatology News (PDF available here).
Legislation Around the Country
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. For a full status report on all the bills CSRO tracks, click here.

Be sure to check out our interactive legislative map tool for additional information about current policy in your state. Plus, don't forget to add your state to your email profile here to receive state-specific updates and action alerts via email.
Step Therapy
  • H.4929: Passed the House, passed the Senate, returned to the House for concurrence with Senate amendments
Upcoming Events
Register Now
Save the Date
  • Exclusive: Member Breakfast at ACR Convergence
  • November 13, 2022 – Philadelphia, PA
  • More information will be shared with member societies in the coming months
  • Fellows Conference
  • March 11, 2023 – San Francisco, CA

Find all of CSRO's event dates by visiting our Upcoming Events page, and check out past events and webinars in our Library.
Please visit the CSRO website for other news and updates, and do not hesitate to contact us with any questions at info@csro.info.
CSRO is a 501c3 nonprofit organization dedicated to ensuring access to the highest quality care for the management of rheumatologic diseases - donate today.