Your Questions Answered: MPSN Contract Overview & Webinar
In response to inquiries from independent rheumatologists regarding the new MedicalRx Specialty Provider Network (MSPN) from OptumRx, CSRO has engaged Mark Watson, a healthcare attorney with Hancock, Daniel & Johnson, P.C. to provide a general overview of one version of their agreement.
In addition to supplying the agreement summary, Mark will be available for follow-up questions via a webinar on December 16 at 5pm CT/6pm ET sign up to join us today.

Thursday, December 16
5pm CT/6pm ET
Federal News: What's Happening on Capitol Hill
TAKE ACTION - Stop a 9% Medicare Reimbursement Cut
Our last update highlighted how the Medicare Physician Fee Schedule includes a cumulative reduction in reimbursement nearing 9% starting January 1.
Such a massive cut to Medicare physician pay would threaten medical practices with yet another financial crisis and endanger vital patient care. 
Make your voice heard by sending a message to Congress and tell them to stop these harmful cuts to Medicare physicians.

The government funding deadline is midnight tomorrow, Dec. 3 – take action now!
Want to learn more about the 2022 Medicare Physician Fee Schedule? Check out NORM's webinar with Judith Gorsuch and Emily Graham of Hart Health Strategies - watch the recording here and view the presentation slides here.
UPDATE - House Passed Build Back Better Legislation
On November 19, the U.S. House passed the Build Back Better (BBB) legislation, which contains wide-ranging provisions related to climate, social programs, and immigration. With regard to healthcare, the legislation includes several coverage and access provisions.
Relevant to rheumatology patients: the BBB reforms Medicare Part D cost-sharing by putting in place a much-needed annual cap on out-of-pocket costs for beneficiaries. Other drug pricing provisions include inflationary rebates and, disappointingly, a repeal of the so-called rebate rule, which was a regulation that would have outlawed payments from drug companies to pharmacy benefit managers in exchange for formulary placement. Finally, the BBB contains a government price negotiation mechanism for prescription drugs, which became more limited than initial proposals through the negotiation process.
CSRO has expressed concern about how this proposal would affect buy-and-bill providers and has joined other Part B medication providers to explore a legislative solution to remove providers from the mechanism altogether, while still providing beneficiaries with immediate cost-sharing relief and ensuring that Medicare experiences significant savings.
Next, the legislation will undergo extensive changes in the Senate, both as a result of substantive negotiations and procedural requirements. One overhang is the recent Congressional Budget Office score, which shows that the BBB will increase the deficit by $367 billion over ten years. The outcome is still unknown, and additional updates will be shared in future CSRO emails.
Mission Focused: NCOIL Annual Meeting
Last month, The National Council of Insurance Legislators (NCOIL) hosted their annual meeting, which brought together state legislators from all over the country who are likely to hear bills related to pharmacy benefit managers, utilization management, and other reforms important to the rheumatology community.

CSRO Treasurer Michael Saitta, MD, MBA (pictured here) and Brian Henderson of our State Government Affairs team represented the CSRO at the meeting, advocating directly with legislators about issues impacting rheumatologists and their patients.
Legislation Around the Country
Check out the list below to see the status of legislation at both the state and federal level that may affect you.

Bills that need your support will include a link for you to take action by sending a template message to lawmakers and make an impact on legislation.

Visit our interactive legislative map tool for additional information about current policy. Be sure to add your state to your email profile here to receive state-specific updates and action alerts via email.
Federal Government
Accumulator Programs:
  • H.R. 5801 – Introduced
Step Therapy:
  • S.464 – Introduced
  • H.R. 2163 – Introduced
Step Therapy:
  • SB 730 – Referred to Banking and Insurance, Health Policy committees
White Bagging:
  • SB 748 – Referred to Banking and Insurance, Appropriations subcommittee on Agriculture, Environment, General Government, and Appropriations committees
Accumulator Programs:
  • S.644 – Virtual hearing on 9/21/21
  • Take Action: S.644
  • H.1053 – Virtual hearing on 9/21/21
Non-medical Switching:
Step Therapy:
  • S.756 – Reported favorably and transmitted to House Ways and Means
  • H.1311 – Reported favorably and transmitted to House Ways and Means
  • Take Action: S.756 & H.1311
Accumulator Programs:
  • HB 4353 – Passed the House and referred to Senate committee on Health Policy and Human Services
  • Take Action: HB 4353
New Jersey
Step Therapy:
  • A 4815 – Passed the Assembly and referred to the Senate Commerce Committee
  • S 3051 – Introduced in the Senate and referred to the Senate Commerce Committee
  • Take Action: A4815 & S3051
Accumulator Programs:
  • HB 135 – Reported favorably by House Committee on Health
  • Take Action: HB 135
Non-medical Switching:
  • HB 451 – Referred to House Insurance Committee
Accumulator Programs:
  • SB 196 – Introduced
  • Take Action: SB 196
  • HB 1664 – Introduced
Non-medical Switching:
  • HB 599 – Re-referred from Insurance to Consumer Affairs Committee
  • Take Action: HB 599
Step Therapy & Prior Authorization:
  • SB 225 – Passed Senate Banking and Insurance Committee
  • HB 225 – Referred to Insurance Committee
  • Take Action: SB225 & HB225
Accumulator Programs:
  • SB 215 – Introduced
  • Take Action: SB 215
  • AB 184 – Introduced
  • LRB 4440/1 – Co-sponsor memo circulated
  • Take Action: LRB 4440/1
Registration Now Open!

Save the Date!

Find all of CSRO's event dates by visiting our Upcoming Events page.
Please visit the CSRO website for other news and updates, and do not hesitate to contact us with any questions at
CSRO is a 501c3 nonprofit organization dedicated to ensuring access to the highest quality care for the management of rheumatologic diseases. Your tax-deductible
donation supports our ongoing advocacy on behalf of the rheumatology community.
Looking for a job? Browse for free.
Have an open position? Posting starts at $200 for 30 days.