Savings at the Pharmacy Counter: New MA/PD Rules
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The Centers for Medicare and Medicaid Services (CMS) released its long-awaited final rule outlining technical and policy changes for Medicare Advantage and Part D prescription drug (MA/PD) plans in the 2023 contract year.
As described in a fact sheet, starting January 1, 2024, CMS will require Part D plans “to apply all price concessions they receive from network pharmacies to the negotiated price at the point of sale, so that the beneficiary can also share in the savings.” This change will benefit beneficiaries in all phases of the Part D benefit, including the coverage gap phase. The policy was finalized with broad support from patient and provider organizations.
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Advocacy Day Success: Michigan Rheumatism Society
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Through the support of an advocacy grant from CSRO, members and staff of the Michigan Rheumatism Society (pictured left) participated in the first Annual MRS Advocacy Day on Tuesday, April 12.
After a briefing from government affairs staff Brian Henderson from CSRO and Scott Kempa from the Michigan State Medical Society, face to face meetings were held with Michigan legislators and their staff throughout the day to discuss how reforms to step therapy laws are needed and to express support for House Bill 4353, which would ensure that all payments made by or on behalf of the insured go toward a patient’s deductible and out-of-pocket costs.
They are already looking forward to holding the event again in 2023!
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Save the Date: State Society Advocacy Conference
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This annual event brings together like-minded rheumatologists and advocates to network within our community, learn from nationally-recognized experts, and strategize about advocacy - we hope to see you there!
Exclusive for members of CSRO: State societies that are members of CSRO receive a stipend to pay for transportation and lodging expenses for up to two representatives to attend the conference and annual business meeting. If you are interested in representing your state society at the SSAC, email us for advanced registration information.
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Awareness in May: Arthritis, Lupus, Osteoporosis
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Arthritis Awareness Month: the Arthritis Foundation is collecting stories to share throughout the month to help others feel less alone and spread awareness of this invisible disease that many don’t understand. Submit a story, and see them all being shared on Twitter and Facebook.
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Osteoporosis Awareness and Prevention Month: CSRO is a member of the Fracture Prevention Coalition which is working to protect bone health and ensure access to DXA testing. Follow them on Twitter and Facebook to learn about all things osteoporosis.
Do you have an awareness activity you'd like us to share? Send us an email at info@csro.info.
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Reminder: FTC Comments due May 25
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The Federal Trade Commission (FTC) has requested input from the public about pharmacy benefit managers (PBMs) and their impact on drug pricing and access to medication.
Submit comments using CSRO's talking points by May 25 to ensure the physician perspective is represented.
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Legislation Around the Country
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ICYMI: Opportunity For Action in Your State
The following states have active legislation that need your support - make your voice heard today:
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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.
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CALIFORNIA
White Bagging
- SB 958: Heard by Senate Appropriations Committee, placed on Appropriations suspense file
COLORADO
Non-medical Switching
- HB 1370: Passed the House, introduced in the Senate, assigned to State, Veterans, and Military Affairs committee
Rebate Pass Through
- HB 1370: Passed the House, introduced in the Senate, assigned to State, Veterans, and Military Affairs committee
Step Therapy
- HB 1370: Passed the House, introduced in the Senate, assigned to State, Veterans, and Military Affairs committee
DELAWARE
Accumulator Programs
- SB 267: Reported out of Senate Banking, Business & Insurance committee
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LOUISIANA
Prior Authorization “Gold Card”
- SB 112: “Gold Card” removed by amendment in Senate Insurance Committee, scheduled for Senate floor on 5/9/22
MAINE
Accumulator Programs
- LD 1783: Passed the legislature, transmitted to the Governor
NEW YORK
Accumulator Programs
- S5299: Approved by Senate Insurance committee, advanced to third reading
TENNESSEE
Step Therapy
- SB 1310: Transmitted to the Governor
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Save the Date!
Find all of CSRO's event dates by visiting our Upcoming Events page, and check out past events and webinars in our Library.
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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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