Federal Update: Improving Seniors' Timely Access to Care Act

On September 14, the U.S. House passed the Improving Seniors’ Timely Access to Care Act, which would streamline and improve the prior authorization process in Medicare Advantage. On the House side, the bill had over 320 cosponsors and had been favorably reported out by the two Committees of jurisdiction. The Senate must now act on the legislation, but the bill has hit an unexpected roadblock: the night before the House vote, the Congressional Budget Office (CBO) released its score of the legislation, finding that it would cost the federal government over $16 billion. This was a far larger score than expected by the bill sponsors, who plan to engage CBO to discuss the baseline assumptions underlying the score and to determine whether minor tweaks to the legislative language could reduce the score without watering down the substance of the reforms.

 

Although this development poses a setback to easy Senate passage, the lead sponsors are committed to reducing the score and/or finding an “offset” for the new spending. Not only have 46 Senators – almost half the chamber – cosponsored the bill, but these 46 are also divided evenly among both political parties. That broad bipartisan support has generated significant momentum and enthusiasm for the lead sponsors to ensure that this legislation is enacted before the end of this year.

CSRO Advocating for You

LCD Issued by Palmetto GBA's MoIDX

Last week, CSRO submitted comments in response to a recently released proposed Local Coverage Determination (LCD) issued by Palmetto GBA’s Molecular Diagnostics Program (MolDX) regarding Molecular Biomarker Testing to Guide Targeted Therapy Selection in Rheumatoid Arthritis (DL39424). In their letter, CSRO argued that “molecular biomarker tests are the first tool offering an objective, science-based approach to identifying appropriate medication therapies for RA treatment and management,” and urged the contractor to “establish a local coverage policy and associated payment for the use of molecular biomarker testing to guide targeted therapy in RA” with certain caveats. Read more in CSRO’s comments.


Nondiscrimination in Health Programs and Activities Rule

In comments to the Department of Health and Human Services (HHS), CSRO expressed its commitment to ensuring patients do not face discrimination based on race, color, national origin, age, disability, or sex, consistent with Section 1557 of the Affordable Care Act, but urged the Department to make resources available that will help practices comply with newly proposed Section 1557 requirements outlined in the Nondiscrimination in Health Programs and Activities rule. Specifically, CSRO asked HHS to develop template policies and procedures, staff educational and training resources, and patient notices and educational materials. CSRO also urged HHS to postpone enforcement until these resources and other technical assistance have been made available.

 

In addition, CSRO suggested that certain policies established under the Medicare program, namely the Self-Administered Drug Exclusion List (SAD List), are discriminatory against patients with disabilities, and called on the Department to work with the Centers for Medicare and Medicaid Services to make modifications to the SAD List criteria to ensure robust beneficiary access to important medication therapies. Read more in CSRO's comments. 

A Time of Transition: CSRO Update

Earlier this month, CSRO held its annual State Society Advocacy Conference which focused on issues at both the state and federal levels impacting rheumatology patients and practices - check out a full recap of the conference here.


During the Annual Business Meeting held in conjunction with the event, our state society members approved a new slate of Board of Directors. Additionally, the CSRO is pleased to announce Dr. Gary Feldman (Los Angeles, CA) as CSRO's new President. Dr. Madelaine Feldman (New Orleans, LA), who has been President of the Board of Directors since 2018, remains on the Executive Committee as Immediate Past President and the inaugural Vice President of Advocacy & Government Affairs, as does Dr. Michael Saitta as the Treasurer, and welcome to Dr. Aaron Broadwell as Secretary.


Thank you to our new and returning Board Members for their service in 2022 - 2023!

Register Today for CSRO's Upcoming Events

Advocacy Insider Webinar: Nov. 2

Join CSRO for a behind-the-scenes look at the legislative process, including why elected officials want to hear from YOU and an overview of easy ways to connect with them about issues facing patients and practices.


Advocacy Insider Part 1:

Demystifying Advocacy

Wednesday, November 2

5pm PT/ 6pm MT/ 7pm CT/ 8pm ET

Register for Webinar

Additional Upcoming Events

CSRO's Advocacy Conference: September 15-17, 2023

Mark your calendars to join us in Austin for CSRO's Advocacy Conference and celebration of our 20th Anniversary! 


CSRO's Fellows Conference: March 10-11, 2023

Save the date to gather with other rheumatology fellows for a unique professional development opportunity that provides insight not taught in academic training.


Find all of CSRO's event dates by visiting our Upcoming Events page.

Legislation Around the Country

What's Happening in the States

CSRO tracks legislative activity relevant to the rheumatology community and their patients – click here to view a full status report.


Be sure to check out our interactive legislative map tool for additional information about current policy in your state.

CALIFORNIA

Step Therapy

  • AB 1880: Vetoed by the Governor

CSRO Resources for You

  • Payer Issues Reporting Form
  • Request assistance with any payer relation issues that may be impacting your patients or office.
  • 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.
  • Action Center
  • Use CSRO's Voter-Voice engagement platform to easily communicate and engage directly with your elected officials.
  • Policy Correspondence Archive
  • Easily access all of CSRO’s policy letters submitted to payers, state, and federal governments as an informational resource.
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.
CSRO is a 501c3 nonprofit organization dedicated to ensuring access to the highest quality care for the management of rheumatologic diseases - donate today.
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