On May 29, CSRO submitted feedback to a joint request for information (RFI) by the Federal Trade Commission, the Department of Justice, and the Department of Health and Human Services. The RFI focused on the topics of private equity and consolidation in healthcare, stating that both research and agency experience have shown that patients and healthcare workers can suffer negative consequences as a result of horizontal and vertical consolidation of a range of different providers.

In the RFI, the three government entities ask for information specifically related to concerning trends and research indicating that certain transactions involving healthcare providers may harm access to healthcare. CSRO’s submission focused on highlighting the negative impacts of consolidation in the pharmacy benefit manager industry, as well as related trends such as insurer acquisition of medical practices and the potential for self-dealing among entities that share an ownership structure.

Last week, CSRO submitted several recommendations to CMS regarding Medicare Advantage (MA) data in response to the agency’s request for information. CSRO highlighted concerns about inadequate access to specialty care, citing cases where MA plans significantly reduced rheumatologist networks, and urged CMS to revise network adequacy criteria, implement wait time standards, and ensure transparent marketing practices to prevent misleading information about physician access and medication coverage.

CSRO also recommended uniform application of prior authorization policies across all medications and better data collection to address "white bagging" practices. These changes aim to increase the availability of data and information and improve program oversight and beneficiary care – read CSRO’s full response here.

CSRO also joined the Alliance of Specialty Medicine in making similar recommendations, focusing on broad issues facing specialty practices and their patients who are enrolled in MA plans – read the Alliance comments here.

CSRO is requesting input from the rheumatology community to gather information about home infusion services.

Please take 3 minutes to complete this brief survey by Sunday, June 16 – thank you for your consideration.

Advocacy Conference

September 20-22

Nashville, TN

Advocating for patient access to care has been the cornerstone of CSRO's mission for more than 20 years, and you're invited to join us September 20-22 in Nashville for our flagship Advocacy Conference!

Registration is complimentary and open to anyone currently working within or retired from the field of rheumatology – visit our website for details and registration.

Virtual Advocacy Day

Wednesday, July 10

Virtual Meetings

Advocate alongside CSRO as we meet with Federal policymakers to highlight legislation of interest to the rheumatology community during our Virtual Advocacy Day! 

Rheumatologists and their practice partners from across the country are invited to join us on July 10 for live, virtual meetings with members of Congress – visit our website to learn more and sign up.

CSRO’s virtual Business of Rheumatology seminar series to help support rheumatology practices in building and strengthening their business has returned!

Log in on Wednesday, July 31, to explore if larger groups, including super groups, are the way forward to maintain private practice in rheumatology through a panel discussion of representatives from Arizona Arthritis and Rheumatology Associates, Articularis Healthcare, Bendcare, and United Rheumatology/Specialty Networks.

As highlighted in the last Bi-Weekly Update, CSRO continues to receive reports from practices about certain biosimilars’ acquisition costs exceeding reimbursement. To aid the rheumatology community in addressing this issue with payers, CSRO has created a resource document to illustrate the extent of the problem.

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.

Be sure to check out our interactive legislative map tool for additional details.

Alabama

Rebate Pass Through

• HB 238: Indefinitely postponed

Alaska

White Bagging

• HB 226: Awaiting transmittal to the Governor

California

Rebate Pass Through

• SB 966: Passed the Senate, delivered to the Assembly

Colorado

White Bagging

• HB 1010: Amended to oncology only and vetoed by the Governor

Gold Card

• HB 1149: Transmitted to the Governor 

New Hampshire

Accumulators

• SB 354: Conference committee appointed

Rebate Pass Through

• SB 555: Conference committee appointed

Rhode Island

Prescription Drug Affordability Board

• S2719: Passed by the Senate, and referred to House committee

Vermont

Utilization Management Reform

• H766: Signed by the Governor

Prescription Drug Affordability Board

• S98: Delivered to the Governor

Virtual Advocacy Day: July 10, 2024

Advocate alongside CSRO as we host live conversations with health care leaders from the U.S. Senate and U.S. House of Representatives.

Business of Rheumatology: July 31, 2024

CSRO's virtual seminar series to help support rheumatology practices in building and strengthening their business.

CSRO Advocacy Conference: September 20-22, 2024

Gather with others in the rheumatology community in Nashville for CSRO's annual Advocacy 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.

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 Rheumatology News.

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.