News
Click here to view CSRO's latest bi-weekly updates, which include current advocacy and legislation news.
Rheum for Action: Use 2022’s advocacy successes and frustrations as a catalyst for the new year
posted: November 14, 2022 to CSRO News
Rheumatology News and the CSRO have partnered to keep rheumatologists regularly informed on the advocacy issues of the day. In this piece, Dr. Mattie Feldman reflects on the successes and frustrations with health policy legislation and regulation and insurance companies in 2022, and shares how this can be used as a catalyst for the year ahead.
Rheum for Action: Employers’ self-funded health plans can leave rheumatology patients vulnerable
posted: September 20, 2022 to CSRO News
Rheumatology News and the CSRO have partnered to keep rheumatologists regularly informed on the advocacy issues of the day. In this piece, Dr. Mattie Feldman shares that CSRO is developing a employer tool kit that educates employers with self-funded health plans about the pitfalls and misinformation that may be given to them by the insurance companies, PBMs, and other third parties that administer their health plan.
Pharmacy Middlemen Deserve Reformers' Attention
posted: August 30, 2022 to CSRO News
Drug pricing reform has received renewed attention in recent months, but one entity always seems to escape unscathed in reform efforts: pharmacy benefit managers (PBMs).
CSRO Policy Update: Summer 2022
posted: August 10, 2022 to CSRO News
The Summer edition of CSRO's bi-annual Policy Update is now available and features exclusive updates on our state and federal advocacy activity.
Rheum for Action: Who’s in charge here? Rheumatologists battle local Medicare policies threatening access, practice sustainability
posted: July 21, 2022 to CSRO News
Rheumatology News and the CSRO have partnered to keep rheumatologists regularly informed on the advocacy issues of the day. In this piece, Dr. Mattie Feldman explains the advocacy work that the Coalition of State Rheumatology Organizations and other groups are undertaking to address local Medicare policies.
Rheum for Action: Will ‘gold card’ legislation and others rein in prior authorizations?
posted: May 23, 2022 to CSRO News
Rheumatology News and the CSRO have partnered to keep rheumatologists regularly informed on the advocacy issues of the day. In this piece, Dr. Mattie Feldman discusses how “gold card” legislation already passed or in the works in several states has potential to reduce prior authorization burdens on clinicians, but there are still some concerns.
Copay Assistance Programs, and Their Trackers, Stay in the Spotlight
posted: May 19, 2022 to CSRO News
The use of tracking systems -- such as copay accumulators and copay maximizers -- to scrutinize patients' use of drug manufacturer copay assistance programs is causing controversy inside and outside of the federal government, as well as concerns among physicians and patients.
Rheum for Action: New law will awaken employers to health care’s ‘transparency gap’
posted: March 16, 2022 to CSRO News
Rheumatology News and the CSRO have partnered to keep rheumatologists regularly informed on the advocacy issues of the day. In this piece, Dr. Mattie Feldman highlights how the Consolidated Appropriation Act of 2020-21 will not only help to eliminate much of the “transparency gap” in the system, but it may encourage employers to work directly with independent physicians’ offices to provide more cost effective and transparent services for their patients.
Provider Groups Miffed Over FTC's Failure to Authorize Study of PBMs
posted: February 24, 2022 to CSRO News
CSRO President Dr. Madelaine Feldman talks with MedPage Today about why pharmacy and provider organizations are disappointed with a decision by the Federal Trade Commission (FTC) not to launch a study into the marketing and financial practices of pharmacy benefit managers (PBMs) -- at least for now.
Vertical integration secures PBMs as ‘arsonists and firefighters’ of drug prices
posted: February 22, 2022 to CSRO News
In the last 4 years, the three biggest pharmacy benefit managers have consolidated influence in the U.S. health care marketplace through vertical integration with insurance carriers.
CSRO Policy Update: Winter 2022
posted: February 21, 2022 to CSRO News
The Winter edition of CSRO's bi-annual Policy Update is now available and features exclusive updates on our state and federal advocacy activity.
Rheum for Action: Could stopping ‘thousand cuts’ by insurers and PBMs help rheumatology’s workforce shortage?
posted: November 12, 2021 to CSRO News
Rheumatology News and the CSRO have partnered to keep rheumatologists regularly informed on the advocacy issues of the day. In this piece, Dr. Mattie Feldman highlights rheumatologists’ frustrations over having the doctor-patient shared decision-making taken out of their hands and given to the insurance companies and their PBMs.
Build Back Better: What You Need to Know
posted: December 17, 2021 to CSRO News
In November, the U.S. House passed the Build Back Better (BBB) legislation, which is now in the Senate, where negotiations are still ongoing.
Improving 340B Will Help Low-Income Patients
posted: December 6, 2021 to CSRO News
CSRO President Dr. Madelaine Feldman explains that in the litany of examples of how the U.S. health care system has become so broken, none is as instructive as the 340B Drug Discount Program.
CSRO attends National Council of Insurance Legislators Meeting
posted: December 2, 2021 to CSRO News
In November, 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.
Rheum for Action: Taking 2021’s rheumatology advocacy momentum into 2022
posted: November 12, 2021 to CSRO News
Rheumatology News and the CSRO have partnered to keep rheumatologists regularly informed on the advocacy issues of the day. In this piece, Dr. Mattie Feldman highlights that in the year ahead, we should prepare to advocate to legislators for policies that prohibit payers from mandating the use of white bagging, brown bagging, and home infusion.
CSRO Leadership Connects with State Lawmakers at National Conference of State Legislatures Annual Meeting
posted: November 10, 2021 to CSRO News
The National Conference of State Legislatures (NCSL) hosted their annual meeting, which brought legislators and advocates from across the country together to network and attend educational sessions on policy.
Drug Prices: It's everybody's fault
posted: October 26, 2021 to CSRO News
CSRO Board member Dr. Harry Gewanter shares his thoughts on the convoluted issue of drug prices in the Richmond Academy of Medicine's fall newsletter.
New Coalition Seeks More Transparent Pharmacy Benefits Managers
posted: September 28, 2021 to CSRO News
CSRO has joined forces with the AIDS Healthcare Foundation, the Community Oncology Alliance, The Food Industry Association, the National Community Pharmacists Association, and the National Federation of Independent Business to establish the Coalition for PBM Reform, which seeks to alter the way pharmacy benefit managers operate to better serve patients, pharmacies and businesses.
CSRO 2021 State Society Advocacy Conference: In Review
posted: September 25, 2021 to CSRO News
CSRO state society member advocates and leadership from around the country gathered virtually in September at the State Society Advocacy Conference (SSAC) to learn about the latest state and federal policy issues impacting the rheumatology community.
Congressional Update: Drug Pricing Reform Still Front and Center
posted: September 24, 2021 to CSRO News
In the House, committees of jurisdiction have finished their work on a $3.5 trillion budget reconciliation package, completing one step on what has become a bumpy road to enactment.
Rheum for Action: Beware patients’ health plans that skirt state laws on specialty drug access
posted: September 20, 2021 to CSRO News
Rheumatology News and the CSRO have partnered to keep rheumatologists regularly informed on the advocacy issues of the day. In this piece, Dr. Mattie Feldman calls on rheumatologists to take third-party administrators to task for convincing businesses to let them “carve out” specialty drug benefits from the larger administrator of the plan by promising huge savings in the employer’s specialty drug spending.
CSRO Transitions to SAIM Board Chair - Arizona Step-Therapy Legislation Signed into Law
posted: July 30, 2021 to CSRO News
The State Access to Innovative Medicines Coalition (SAIM) is the primary organizing vehicle for step-therapy reform and out-of-pocket cost legislation in the states. CSRO has recently transitioned to a new role as the Board’s chair position and is helping to organize and consult on efforts to reform step-therapy and other legislation nation-wide.
CSRO Hosts First Annual Hill Day
posted: July 28, 2021 to CSRO News
On July 27, CSRO leadership from around the country, along with State Society members, virtually assembled to voice their policy concerns with congressional leaders on Capitol Hill.
New coalition calls for statewide board to control prescription drug costs
posted: July 20, 2021 to CSRO News
A new coalition is calling on Virginia legislators to create an oversight board aimed at lowering prescription drug costs and CSRO Board member Dr. Harry Gewanter explains why this is important and how it can help.
Rheum for Action: Legislative wins set groundwork for future success
posted: July 16, 2021 to CSRO News
Rheumatology News and the CSRO have partnered to keep rheumatologists regularly informed on the advocacy issues of the day. In this piece, Dr. Madelaine (Mattie) Feldman recounts recent advocacy wins across states in fighting copay accumulators, step therapy, and pharmacy benefit managers.
Prescription prices still out of control (Opinion)
posted: July 13, 2021 to CSRO News
While some progress has been made toward ensuring patients receive the discounts offered by manufacturers to save money every single time they buy medicine, more transparency is still needed to stop companies from using rebates to game the system and block the appropriate drugs doctors prescribe.
Louisiana White-Bagging Law: A Stepping Stone for Other States
posted: June 30, 2021 to CSRO News
A new bill in Louisiana prevents payers regulated by the state from mandating the use of white-bagging. Governor John Bell Edwards recently signed SB 191 into law.
Prioritize Doctors' Offices for Part B Drugs
posted: June 30, 2021 to CSRO News
When looking at Part B drug spending and potential reform, there is one aspect that has remained unexplored - the physicians office.
Letters: Middlemen in drug industry forcing higher prices on patients
posted: June 30, 2021 to CSRO News
The decisions Pharmacy Benefit Managers (PBMs) make often result in vital drugs being unaffordable for many patients.
CSRO Policy Update: Summer 2021
posted: June 29, 2021 to CSRO News
The Summer edition of CSRO's bi-annual Policy Update is now available and features exclusive updates on our state and federal advocacy activity.
Doctors: Decisions by PBMs make vital drugs unaffordable for many patients
posted: June 15, 2021 to CSRO News
CSRO President Dr. Madelaine Feldman explains that the entire formulary construction paradigm in the U.S. is geared toward one thing - profits.
Tennessee and Connecticut become latest States to limit use of Accumulator Adjustment Programs
posted: June 7, 2021 to CSRO News
Momentum in the states to reform the use of accumulator adjustment programs continued as many states wrap up their legislative work for the year - Tennessee and Connecticut became the 9th and 10th states to limit the use of accumulator adjustment programs.
CSRO Meets with State Policymakers at Executive Meeting in Puerto Rico
posted: June 7, 2021 to CSRO News
CSRO attended the National Conference of State Legislatures (NCSL) in Puerto Rico at their first in-person executive meeting since the pandemic put a hold on travel.
No Veto in 2021: New Montana Governor Signs Pharmacy Benefit Manager Oversite Act into Law
posted: May 20, 2021 to CSRO News
During the 2019 legislative session in Montana, then Governor Steve Bullock vetoed a bill to place regulations around Pharmacy Benefit Managers (PBMs).
Rheum for Action: How I got started in advocacy
posted: May 12, 2021 to CSRO News
Rheumatology News and the CSRO have partnered to keep rheumatologists regularly informed on the advocacy issues of the day. This inaugural piece tells how CSRO President Dr. Madelaine (Mattie) A. Feldman views advocacy and how she found her way to action.
Op-Ed: Insurers Bet Big on Bribing Patients
posted: May 12, 2021 to CSRO News
Last month, psoriasis patients covered by Cigna received a curious letter from the insurance giant's pharmacy management division. They could receive a $500 debit card from Cigna, with just one string attached: they would have to switch to a different medication, one preferred by the insurer.
Want to Lower Drug Costs? End ‘Rebate Walls’
posted: May 12, 2021 to CSRO News
One of the most important areas for reform when looking to reduce drug prices is rebate walls, as shared by CSRO President Dr. Madelaine A. Feldman and Wayne Winegarden in this op-ed for the Pacific Research Institute’s Center for Medical Economics and Innovation.
Patients Rising Podcast: Making Lupus Treatments Accessible
posted: May 12, 2021 to CSRO News
CSRO Board member Dr. Mark Box joined Patients Rising to have an honest discussion about the clinical side of Lupus.
For the patients: Aid access to critical medications
posted: May 12, 2021 to CSRO News
In a guest piece for the Arkansas Democrat-Gazette, CSRO Treasurer and Arkansas Rheumatology Association president Dr. Michael Saitta shares his thoughts on why step therapy reform is needed.
West Virginia Enacts One of the Most Comprehensive Drug Pricing & Transparency Bills in the Nation
posted: May 7, 2021 to CSRO News
As prescription drug prices continue to rise, policymakers from across the country are looking for ways to lower costs for patients - this year, West Virginia did more than look.
Arkansas Enacts Flurry of Patient Protections
posted: May 7, 2021 to CSRO News
Arkansas' efforts to protect pharmacies from the predatory and anti-competitive actions of Pharmacy Benefit Managers (PBMs) culminated in the Rutledge v. PCMA case heard in the United States Supreme Court.
Kentucky Accumulator Bill Signed Into Law
posted: April 20, 2021 to CSRO News
On March 25, 2021, Kentucky Governor Andy Beshear signed SB 45 into law, preventing the indiscriminate use of accumulator adjustment programs for state regulated plans in Kentucky and becoming the seventh such accumulator law in the United States.
Updates from ATAP: April 2021
posted: April 16, 2021 to CSRO News
As a Principal Member of the Alliance for Transparent & Affordable Prescriptions (ATAP), CSRO is sharing their latest member update.
Report Details Plans Across the Country with Accumulator Programs in 2021
posted: March 30, 2021 to CSRO News
Accumulator adjustment programs are a newly emergent utilization management tool used by PBMs, that have grown increasingly prevalent over the past few years.
CSRO 2021 Fellows Conference: In Review
posted: March 23, 2021 to CSRO News
On March 13, 2021, the CSRO held its 15th Annual Fellows Conference. Its first (and hopefully only) year as a virtual event, this was the first time that it was open to both fellows and practicing rheumatologists, and attendance was at an all-time high.
Most Favored Nation Rule - CSRO Comments and Resources for Rheumatologists
posted: December 18, 2020 to CSRO News
Press Release: Rheumatologists Applaud SCOTUS’ Unanimous Decision that Arkansas’ PBM Law is Not Preempted by ERISA
posted: December 11, 2020 to CSRO News
Today, the Supreme Court of the United States unanimously upheld Arkansas’ Pharmacy Benefit Manager (PBM) law in the Rutledge V. PCMA case.
UHC Expanding Accumulator Programs for Provider Administered Drugs
posted: October 16, 2020 to Federal
Accumulator adjustment programs are a utilization management tool that prevent the value of co-pay assistance from applying to a patient’s deductible, leaving patients vulnerable to high out-of-pocket expenses when the value of their co-pay assistance runs out.
New Phase 3 Provider Relief Funds Announced
posted: October 2, 2020 to Federal
The COVID-19 pandemic has substantially disrupted many private medical practices across the country. New operational expenses, reduced service and revenues, and other variables have threatened the viability of many of these practices. Rheumatology has not remained unscathed.
Recapping the 2020 State Society Advocacy Conference
posted: September 18, 2020 to CSRO News
CSRO hosted its annual State Society Advocacy Conference. While this was the 8th iteration of the SSAC, it also marked the first time the conference occurred in a virtual format. Despite the venue changed forced by the pandemic, CSRO was pleased to present an excellent program with strong attendance.
Report Details Prevalence of Accumulator Adjustment Programs
posted: August 21, 2020 to CSRO News
Accumulator adjustment programs are a newly emergent utilization management tool used by PBMs, that have grown increasingly prevalent over the past few years. The programs prevent the value of co-pay assistance from applying to a patient’s deductible, leaving patients vulnerable to high out-of-pocket expenses when the value of their co-pay assistance runs out.
CSRO Continues Advocacy Opposing BCBST White-bagging Policy
posted: July 24, 2020 to CSRO News
CSRO Opposes BCBST White-bagging Policy
HHS Issues Slew of Clarifications for Provider Relief Fund Recipients
posted: June 26, 2020 to Federal
After announcing plans to distribute an addition $15 billion to participants in state Medicaid and CHIP programs, the Department of Health and Human Services issued a number of clarifications for providers who received funds from the general distribution fund.
CSRO Renews Opposition to BCBST Whitebagging Policy
posted: June 12, 2020 to CSRO News
Late last year, Blue Cross Blue Shield of Tennessee (BCBST) announced a sweeping policy that would mandate the use of a white-bagging acquisition system for a substantial number of covered lives in Tennessee. The policy would have, in effect, disallowed the use of buy and bill.
Updates to Louisiana Step-therapy Reform Statute Advance through Legislature
posted: May 29, 2020 to State
For Louisianans with chronic health conditions, it is important to get timely access to the medications and treatments they need. We must ensure that doctors and their patients, not a one-size-fits-all insurance policy, make the right decision for the right treatment at the right time.
CSRO Comments on CMS Telehealth and Home Administration
posted: April 30, 2020 to Federal
In response to rapidly evolving circumstances surrounding the COVID-19 pandemic, CMS has made numerous interim revisions to its policies. These changes are designed to streamline patient access to care during the pandemic and large scale social distancing.
South Dakota Becomes Latest State to Enact Step Therapy Reform
posted: April 21, 2020 to State
On Tuesday, March 24th South Dakota Governor, Kristi Noem, signed SB 155 into law as S.J. 588. The law provides sorely needed reforms to the step-therapy process for patients and providers in South Dakota.
Add to the COVID-19 Global Rheumatology Alliance Registry
posted: April 8, 2020 to CSRO News, Federal
CSRO is imploring its membership to utilize the COVID-19 Global Rheumatology Alliance Healthcare Provider Entered Registry during the unprecedented era of global pandemic.
CSRO Leadership Gives Testimony at FDA/FTC Biosimilar Workshop
posted: March 25, 2020 to CSRO News
On March 9, 2020, the Federal Trade Commission and the Food and Drug Administration co-sponsored a public workshop focusing on promoting competition in biologics markets. The workshop was held at the FDA’s White Oak Campus in Silver Spring, Maryland and was also viewable via webcast.
CSRO 2020 Fellows Conference Round-Up
posted: March 17, 2020 to CSRO News
On March 7th, 2020, the CSRO held its annual Fellows Conference in San Francisco. Attending fellows were introduced to a network of experienced physicians that they can tap into as they prepare for their futures.
CSRO Policy Update, March 2020, Issue 10
posted: March 10, 2020 to Policy Update
With the turning of the decade I have recently been reflecting on CSRO’s growth and achievements over the course of the past ten years.
Statement from CSRO President On New BCBST Policy
posted: February 12, 2020 to CSRO News
Following a press release issued by BlueCross BlueShield of Tennessee attacking the Coalition of State Rheumatology Organizations for exposing a policy that will prove to harmful to patients, Dr. Madeline Feldman, CSRO’s President, issued this statement.
CSRO Releases New Legislative Map Tool Resource
posted: February 10, 2020 to CSRO News
CSRO has developed a new legislative map tool which serves as a clearinghouse of both active bills and enacted legislation.
CSRO Opposes New Policy by BCBS Tennessee
posted: January 29, 2020 to CSRO News, Federal
CSRO physicians are voicing concern for patients who will fall victim of a dangerous new prescription policy. New requirements from BlueCross BlueShield (BCBS) of Tennessee, which may be a bellwether for other insurers, are reversing the trend providers have achieved in keeping prices down for physician administered medications.
Florida Rep. Jackie Toledo Going After the PBM Problem
posted: December 19, 2019 to State
This week, Jackie Toledo, a member of the Florida House of Representatives, filed legislation that would lower prescription drug prices for patients and protect small pharmacy owners by regulating pharmacy benefit managers (PBMs). The passage of her bill, HB 961, would be a monumental achievement in the crusade for PBM transparency.
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CSRO President Testifies Before Florida Senate Committee
posted: November 20, 2019 to CSRO News, State
CSRO President, Madelaine Feldman, MD, FACR, Testifies Before the Florida Senate Health Policy Committee, Explaining PBM Practices and How They are Hurting Florida’s Patients
Recapping the ACR Annual Meeting
posted: November 20, 2019 to CSRO News
Earlier this month, CSRO’s officers and board of directors traveled to Atlanta, Georgia to attend the American College of Rheumatology’s annual meeting.
Ohio PBM Reform Sees Immediate Results
posted: October 17, 2019 to State
For the last couple of years, the issue of Pharmacy Benefit Managers (PBMs) and their impact on the health care system has been a topic of much concern in both the state of Ohio and the nation as a whole.
Highlights from CSRO’s 2019 State Society Advocacy Conference (SSAC)
posted: September 20, 2019 to CSRO News
CSRO’s 2019 SSAC conference brought rheumatology advocates together from across the country to inspire action on issues affecting the practice of rheumatology.
CSRO Policy Update, August 2019, Issue 9
posted: August 30, 2019 to CSRO News, Policy Update
As CSRO prepares for the 2019 State Society Advocacy Conference (SSAC), healthcare has moved to the fore of national political conversations, providing the rheumatology profession much to discuss. Since its inception, CSRO’s guiding mission has been to ensure excellence in the field of rheumatology for rheumatologists and the patients that we take care of.
Federal Rebate Rule Withdrawn by White House
posted: July 12, 2019 to Federal
On July 11th, the White House announced that it was withdrawing its proposal to reformulate the way drug rebates work in federal programs.
CMS Issues Final Rule Affecting Patient Access and Prescription Drug Affordability
posted: June 14, 2019 to Federal
The Centers for Medicare and Medicaid (CMS) published its “Medicare Advantage and Part D Drug Pricing Final Rule” in May which seeks to increase drug pricing transparency, lower prescription drug costs, and improve patient medication adherence.
CSRO President Testifies Before Congress
posted: May 30, 2019 to CSRO News, Federal
Last week, the House Energy and Commerce Subcommittee on Health held a hearing entitled: “Improving Drug Pricing Transparency and Lowering Prices for American Consumers.” CSRO President, Dr. Madelaine Feldman, was invited to represent the Alliance for Specialty Medicine and deliver testimony at the hearing.
FDA Releases Final Guidance on Interchangeable Biosimilars
posted: May 24, 2019 to Federal
Last week, the FDA released its long anticipated final guidance for industry on “Considerations in Demonstrating Interchangeability with a Reference Product.”
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CSRO offers Federal Policy Virtual “Town Hall” to Rheumatology Community
posted: April 9, 2019 to CSRO News, Federal
The gridlock immobilizing Congress has slowed the progress of health care legislation significantly, but it has not stopped key Federal agencies from proposing and implementing policies that have a far reaching impact on the practice of rheumatology.
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CSRO Comments on Proposed Rule to Eliminate Safe Harbor Protections for Prescription Drug Rebates
posted: April 8, 2019 to CSRO News, Federal
The Coalition of State Rheumatology Organizations (CSRO) recently submitted comments on the Department of Health and Human Services (HHS) proposed rule amending the Federal anti-kickback statute.
Wisconsin Step Therapy Reform a Coalition Effort
posted: March 11, 2019 to State
CSRO, in partnership with the Wisconsin Step Therapy Coalition is taking the lead on step therapy reform in the state.
CSRO’s Dr. Robert Levin Discusses Drug Pricing in the U.S.
posted: February 28, 2019 to CSRO News, Federal
CSRO Board Member, Robert Levin, participated in the Healthcare Policy podcast on February 18 to discuss federal prescription drug pricing reform. In his capacity as a practicing physician, and president the Alliance for Transparent and Affordable Prescriptions, Dr. Levin provided expert testimony on drug pricing reform proposals and how the drug supply chain works.
The CSRO Holds Fellows Conference with Record Attendance
posted: February 14, 2019 to CSRO News
On February 9, 2019, the CSRO held its annual Fellows Conference in San Francisco, complete with a number of presentations on topics that surround today’s Rheumatologist.
Indiana Demands Policy Against Forced Medication Switches
posted: February 13, 2019 to State
Non-medical switching is a strategy used by health plans to reduce expenses by switching the prescription for a stable patient to a “preferred” drug — for reasons unrelated to the patients’ well-being and in some cases without warning.
Illinois Non-Medical Switching Law in Effect
posted: January 29, 2019 to State
A new law in Illinois ensures that commercial health plans deliver on policies they market and sell to Illinoisans. Prior to January 1st of this year, insurers in Illinois could change prescription drug coverage on a patient at any point during the year, and while patients were still locked into their plan. This practice is referred to as “non-medical switching” and can have serious negative health effects for patients.
PBMs and New Approaches to Drug Pricing in 2019
posted: January 10, 2019 to Federal
Without a doubt, lowering list-prices for prescription drugs was a national focus in 2018. Coupled with numerous advocacy organizations bringing increased awareness to Pharmacy Benefit Managers’ (PBMs) unfair practices, and their effect on drug prices, several reforms have sparked across the U.S. and are expected to increase in intensity in 2019.
CSRO Policy Update, January 2019, Issue 8
posted: January 3, 2019 to CSRO News, Policy Update
As the new year begins, I would like to reflect on the tremendous organizational successes that CSRO achieved in 2018. Over the past couple of years, CSRO made a commitment to deepening its ties with the societies it represents, and its allied patient and provider organizations. This year CSRO traveled to 20 state society meetings to bring increased awareness to the issues impacting practicing rheumatologists and patients in the U.S.
CSRO Submits IPI Comments
posted: January 3, 2019 to CSRO News, Federal
Prior to commenting on the proposed International Pricing Index Model (IPI) for Part B drugs, CSRO leadership met with Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma to convey rheumatology's perspective.
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CSRO Talks Accumulator Adjustment Programs at CBI Summit
posted: December 21, 2018 to CSRO News
Accumulator Adjustment Programs have become an increasingly prevalent issue since CSRO was first made aware of them in late 2017. Since then, the programs have been progressively crossing over from the employer to commercial space.
Hospitals Beginning To Practice Non-Medical Switching
posted: November 29, 2018 to State
CSRO has been fielding reports from physicians around the states who have found that their patients are no longer able to access their prescribed treatment. Some hospital systems are no longer carrying biologic originator products, meaning that patients must find an alternative site of care.
Express Scripts Announces New Formulary Design Option
posted: November 14, 2018 to Federal
This week, Express Scripts announced that it would provide clients with the ability to opt for its new National Preferred Flex Formulary Design. As opposed to favoring drugs that garner the most rebate dollars, the new benefit design intends to favor drugs that have lower list prices to begin with.
CSRO Hosts State Society Leaders at the ACR
posted: November 1, 2018 to CSRO News, State
On Monday, October 22nd, CSRO hosted a breakfast for state rheumatology society leaders present at the ACR. Attendees had the opportunity to learn more about emergent patient access issues, CSRO’s plans for 2019, and hear from a speaker who discussed implementation and compliance issues with existing patient access laws.
CSRO Discusses New Drug Payment Model with Key Agency Officials
posted: October 30, 2018 to CSRO News, Federal
Last week, CSRO’s Past President and National Advocacy Chair, Michael Schweitz, MD, participated in one-on-one discussions with Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma and Special Advisor to the Administrator Jeet Guram, MD, to discuss details about the Trump Administration’s potential International Pricing Index Model for Medicare Part B Drugs.
New Data Emerges on Co-Pay Accumulator Programs
posted: September 27, 2018 to CSRO News
The CSRO has been deeply concerned about the expanded implementation of a new utilization management tool known as co-pay accumulator programs over the course of 2018.
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Annual State Society Advocacy Conference a Success
posted: September 25, 2018 to CSRO News
The CSRO was excited to host many members of the state rheumatology societies and other partners in Chicago on Saturday, September 15th for the annual State Society Advocacy Conference (SSAC).
CSRO Policy Update, August 2018, Issue 7
posted: August 28, 2018 to CSRO News, Policy Update
As the last of the 2018 regular sessions wind down across the states, CSRO is happy to report that the year to date has been marked by a number of successes on the patient access front.
Illinois Enacts Non-medical Switching Protections
posted: August 28, 2018 to State
On Friday, August 24th, Illinois’ Governor signed HB4146 into law, providing patients much needed protections from non-medical switching.
CSRO Discusses Part B and D with CMS
posted: August 8, 2018 to CSRO News, Federal
Members of CSRO’s executive board recently met with CMS to discuss Part B and D drug pricing. Doctors Michael Schweitz, Madelaine Feldman, Greg Schimizzi traveled to D.C. to present CSRO’s feedback on recent proposals and provide rheumatology’s perspective on the programs.
CSRO attends National Conference of State Legislatures
posted: August 6, 2018 to CSRO News, State
Each year state legislators from across the country congregate to discuss innovative solutions that can be implemented to solve problems faced in common by various state legislatures.
2018 Session Capped with Approval of Three States’ Biosimilar Measures
posted: July 19, 2018 to State
Over the course of the past year, interchangeable biosimilar substitution laws with physician communication provisions have continued to find enormous success in the states.
CSRO Responds to RFI Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs
posted: July 16, 2018 to CSRO News, Federal
CSRO has submitted their comments regarding the Request for Information (RFI) by the Department of Health and Human Services.
CSRO Attends FSR Conference
posted: July 16, 2018 to CSRO News, State
CSRO staff was pleased to attend the 2018 Florida Society of Rheumatology Conference in Orlando, Florida.
Maine Legislature Moves to Protect Patients
posted: June 29, 2018 to State
Late in Maine’s 2018 session, the legislature passed two separate patient protections measures of benefit to patients battling chronic illnesses.
Minnesota Enacts Step-therapy Reform Measure
posted: May 21, 2018 to State
On Friday, May 15th, Governor Mark Dayton of Minnesota signed HF3196 into law providing important patient protections to Minnesota patients.
Non-Medical Switching Protections Advance in Illinois
posted: May 14, 2018 to State
HB4146, a bill that protects patients from mid-year formulary changes, has been making steady progress in the Illinois legislature this year. After passing the House, it was assigned to the Special Committee of Medicaid Managed Care, where it was heard in a subject matter hearing on Wednesday, May 9th.
Alaska Legislature Approves Biosimilar Substitution Measure
posted: May 1, 2018 to State
Pending the Governor’s signature, passage of the law would cap a multi-year effort to improve future uptake of interchangeable biosimilars that faced numerous obstacles.
CSRO Travels to the Wisconsin Rheumatology Association’s Annual Meeting
posted: March 23, 2018 to State
​Last weekend CSRO Vice President, Dr. Madelaine Feldman, traveled to the Wisconsin Rheumatology Association’s annual meeting to represent CSRO, and educate attendees on the role that Pharmacy Benefit Managers (PBMs) play in inflating the price of prescription drugs.
Michigan Enacts Biosimilar Substitution Measure
posted: March 9, 2018 to State
In late February, Michigan enacted a biosimilar substitution law that promises to improve uptake of biosimilars, while maintaining appropriate patient protections by requiring notification of substitutions to prescribers.
New Mexico Legislature Send Step-Therapy Reform to Governor’s Desk
posted: February 14, 2018 to State
The New Mexico state legislature overwhelmingly approved SB 11, a bill that promises to reform the use of step-therapy protocols by insurers.
CSRO Nominee Selected for CMS Technical Expert Panel
posted: February 8, 2018 to CSRO News
The CSRO is pleased to announce that its nominee, Kent “Kwas” Huston, MD, from the Kansas City Physicians Partners, has been selected to serve on the Centers for Medicare & Medicaid Services (CMS) Technical Expert Panel (TEP).
CSRO Policy Update, January 2018, Issue 6
posted: January 30, 2018 to CSRO News, Policy Update
The CSRO closed out 2017 with legislative and regulatory victories across the country that positively affected the lives of our patients and practices.
CSRO & Allies Talk Utilization Management in Albany
posted: January 18, 2018 to State
On Tuesday, January 16th CSRO staff joined allies in Albany, New York to educate lawmakers on utilization management, and pending legislation that promises to improve patient access and continuity of care.
CSRO Presents on PBMs at the Board of Hispanic Caucus Chairs Conference
posted: December 14, 2017 to CSRO News, Federal
CSRO Vice President, Dr. Madelaine Feldman recently presented on Pharmacy Benefit Managers and utilization management tools at the Board of Hispanic Caucus Chairs meeting in Las Vegas, Nevada.
FSR President Testifies on PBMs and the Rebate System
posted: December 14, 2017 to State
Dr. Robert Levin, President of the Florida Society of Rheumatology recently testified to the House Health Innovation Subcommittee on the role that Pharmacy Benefit Managers have played in inflating the cost of prescription drugs.
CSRO & FSR Discuss Utilization Management in Tallahassee
posted: December 11, 2017 to CSRO News, State
On Tuesday, December 5th, CSRO hosted a reception for Florida legislators in partnership with the Florida Society of Rheumatology (FSR). An array of stakeholders including patients and physicians met and spoke with legislators that are deeply invested in CSRO and FSR’s shared priorities.
FDA Biosimilars Educational Material
posted: December 7, 2017 to Federal
To date, the U.S. Food and Drug Administration (FDA) has approved seven biosimilars, and some are already on the market. As the biosimilars market continues to grow, there are still a lot of questions from both patients and physicians about these important new treatment options.
CSRO Opposes Efforts to Establish a National Benchmark Plan Standard for Prescription Drugs
posted: November 29, 2017 to CSRO News, Federal
The CSRO has submitted comments to CMS expressing concerns with their intent to establish a national benchmark plan standard for prescription drugs in future years.
CSRO Responds to Federal Innovation Center RFI
posted: November 20, 2017 to Federal
The CSRO has responded to a request for information (RFI) from the Innovation Center as the federal agency plans for a new direction. The comments submitted focus on specific issues that uniquely impact practicing rheumatologists and the patients they serve.
CSRO Presents at the Patient and Health Advocacy Bio Summit
posted: October 5, 2017 to CSRO News, Federal
Dr. Madelaine Feldman traveled to Washington D.C. recently to attend the Patient and Health Advocacy Bio Summit.
CSRO and Allies Submit Comments to Anthem on Utilization Management Changes for Osteoarthritis Patients
posted: September 27, 2017 to CSRO News
As patient and physician advocates, the Coalition of State Rheumatology Organizations (CSRO) actively monitors changes that affect physician’s ability to effectively treat their patients and operate their practices.
CSRO Delivers Testimony on Utah Step Therapy
posted: September 22, 2017 to CSRO News, State
On September 20, 2017, Dr. Joshua Stolow traveled to Utah to testify on the necessity of patient protection legislation addressing step therapy protocols.
CSRO Submits Comments to CMS on Proposed Revisions for 2018
posted: September 13, 2017 to CSRO News, Federal
As patient and physician advocates, the CSRO actively monitors regulatory changes that affect physician’s ability to effectively treat their patients and operate their practices. As such, the CSRO took note of and discussed revisions proposed by the Center for Medicare and Medicaid Services for 2018.
Legal Challenges to Nevada Drug Transparency Law Forecast Future Hurdles for Lawmakers
posted: September 6, 2017 to State
Nevada Governor Brian Sandoval signed a landmark drug transparency law in June that focuses on diabetes drug manufacturers and their intermediaries more broadly.
Escalating Cost of Prescription Drugs Facilitated by Lack of Transparency
posted: August 30, 2017 to Federal
The expansive list of actors involved in delivering prescription drugs to patients substantially inhibits patients from making fully informed treatment and purchasing decisions.
Step-Therapy Legislation Nears Effective Enrollment Date in Texas
posted: August 21, 2017 to State
Patients and physicians in Texas won a major victory against the step-therapy protocols instituted by insurance companies this spring with the passage of Senate Bill 680.
CSRO Submits Comments in Response to 2018 QPP Proposed Rule
posted: August 21, 2017 to CSRO News, Federal
The Coalition of State Rheumatology Organizations (CSRO) and several state societies submitted comments to CMS today in response to the CY 2018 Updates to the Quality Payment Program.
Lawsuits Target Pharmacies Over Prescription Drug Costs
posted: August 11, 2017 to CSRO News, Federal
As patients, providers, and politicians alike look for answers to the soaring cost of prescription drugs, some patients have taken matters into their own hands. A series of lawsuits have popped up across the country targeting pharmacies and their relationship to pharmacy benefit managers.
FDA Creates Pathway for Interchangeable Biologics
posted: June 29, 2017 to Federal, State
The FDA has released its highly anticipated but long delayed interchangeability guidelines, and the market seems primed for new developments.
AMA House of Delegates Policy Update
posted: June 28, 2017 to Federal
At the AMA’s Annual House of Delegate Meeting, hundreds of medical professionals gathered to discuss and address a wide range of healthcare issues, including the opioid crisis, physician burnout, regulating physician assistants and advanced practice registered nurses, and of course, healthcare reform and drug pricing.
States move to enforce FDA’s Biosimilar Interchangeability Guidelines from the Ground Up
posted: June 27, 2017 to Federal, State
The Food and Drug Administration’s guidelines for biosimilar interchangeability, released in January 2017, have come under renewed focus with concerns about patients being switched onto biosimilars by insurers without consultation with their physicians.
California Takes Aim at Pharmacy Benefit Managers With Assembly Bill 315
posted: June 23, 2017 to State
California’s Assembly Bill 315, which takes aim at Pharmacy Benefit Managers (PBMs), recently cleared the Assembly floor, and is now headed to the Senate for consideration.
State Rheumatology Organizations Join Alliance for Transparent & Affordable Prescriptions
posted: June 20, 2017 to State
The Florida Society of Rheumatology, New York State Rheumatology Society, and California Rheumatology Alliance today became the newest members of the Alliance for Transparent & Affordable Prescriptions (ATAP), a new coalition of provider and patient groups concerned about the role of pharmacy benefit managers (PBMs) in driving up drug costs.
Senate HELP Committee Wades into Drug Prices Debate
posted: June 16, 2017 to Federal
Despite intractable differences between the parties on healthcare policy, the Senate’s Health, Education, Labor, and Pensions Committee (HELP) convened a hearing this week to frame future efforts in combating high drug prices.
The Atlantic Hosts Biosimilars Policy Roundtable.
posted: June 15, 2017 to State
The Atlantic recently concluded its policy roundtable on biosimilars June 7th, with the third and final installment titled: “The Next Drugs: An Atlantic Policy Update on Biosimilars.”
Leading Health Organizations Announce Launch of Alliance for Transparent & Affordable Prescriptions
posted: June 13, 2017 to Federal
Health leaders today announced the launch of the Alliance for Transparent & Affordable Prescriptions (ATAP), a coalition of provider and patient groups concerned about the practices of pharmacy benefit managers (PBMs) driving up drug costs.
Maryland Enacts Biosimilars Bill
posted: May 31, 2017 to State
Maryland became the 35th state to approve of regulations and access for biosimilar medicines.
Minnesota Enacts HF712
posted: May 25, 2017 to State
Minnesota's Governor signed HF712 into law, a bill for biosimilars.
CSRO Policy Update, April 2017, Issue 5
posted: May 24, 2017 to CSRO News, Policy Update
In this issue: President’s Message; States Stride Toward Addressing; Patient Access Legislation; State Maps on Step Therapy & Biosimilars; Fellows Assemble in San Francisco to Prepare for Next Step; The Alliance for Transparent & Affordable Prescriptions; The Rebate System; ARA: CSRO Vice President Presents on PBMs and the Rebate System; CSRO discusses Biosimilars, Drug Pricing, and PBMs with CRA; CSRO Promotes Advocacy at 2017 CCR Conference; CSRO Participates in 2nd Annual National Policy & Advocacy Summit; Save the Date
Step Therapy Legislative Update: Texas Governor Signs Step Therapy Bill into Law
posted: May 24, 2017 to State
The CSRO is pleased to announce that Texas Governor Greg Abbott has officially signed step therapy bill SB 680 into law.
ARA: CSRO Vice President Presents on PBMs and the Rebate System
posted: May 15, 2017 to CSRO News, State
The CSRO is pleased to report that CSRO Vice President Madeleine Feldman, MD, FACR, presented at the Arkansas Rheumatology Association, giving attendees an inside look at rising drug prices and the hidden rebate system controlled by pharmacy benefit managers (PBMs).
Biosimilars Bill headed to Nebraska Governor
posted: May 10, 2017 to State
Legislation that provides the substitution and regulation of biosimilars, LB481, was approved by Nebraska’s Unicameral Legislature on a vote of 47 – 0. The bill now goes to Governor Pete Ricketts for his expected signature.
Step Therapy Legislative Update: Texas Bill is Headed to Governor’s Desk
posted: May 10, 2017 to State
The CSRO is happy to announce that SB 680, step therapy bill introduced in the Texas Senate on January 31, has passed both the Senate and the House and is now headed to Governor Greg Abbott’s desk.
Step Therapy Legislative Update: Iowa Governor Signs Step Therapy Bill into Law
posted: May 10, 2017 to State
The CSRO is very happy to announce that Iowa Governor Terry Branstad has officially signed HF 233, step therapy bill introduced in the Iowa House by Representative Joel Fry (R, 27th) on January 23, into law.
Biosimilars Bills Moved in South Carolina and Nebraska
posted: May 1, 2017 to State
HB3438 was signed by South Carolina Governor Henry McMaster. In Nebraska, LB481, a bill for biosimilars access and regulation, was approved on first round debate.
State Advocacy Spotlight: Step Therapy Legislation Continues to Progress in Florida
posted: April 24, 2017 to State
Like other states across the country, efforts to address step therapy in Florida are underway and making great progress as key legislation continues to move forward.
Biosimilars Bill Signed in Kansas
posted: April 19, 2017 to State
On April 13, HB 2055 was signed by Governor Sam Brownback. It included critical patient safety rules that involved a communication within 5 business days from pharmacists to physicians about any biosimilar substitutions.
Step Therapy Legislative Update: Iowa Bill Makes Its Way to Governor’s Desk
posted: April 18, 2017 to State
The CSRO is pleased to announce that HF 233, step therapy bill introduced in the Iowa House by Representative Joel Fry (R, 27th) on January 23, has passed both the House and the Senate and is now headed to Governor Terry Branstad’s desk.
CRA: How Will Biosimilars Change Rheumatology, Rising Drug Prices: Exposing the Hidden Rebate System
posted: April 14, 2017 to State
The CSRO was delighted to join the California Rheumatology Alliance in an informal presentation on the effect of biosimilars on rheumatology, and an inside look at rising drug prices and the hidden rebate system controlled by pharmacy benefit managers (PBMs). The panel that presented included Dr. Greg Schmizzi on biosimilars, with Dr. Madelaine Feldman, Pharmacist Keith Bradbury, and Attorney David Balto on PBMs.
Biosimilars Bill Awaits Governor’s Signature in South Carolina
posted: April 13, 2017 to State
HB3438 has unanimously passed both legislative chambers in South Carolina, and awaits Governor Henry McMaster’s signature.
Biosimilars Bill Signed in New Mexico
posted: April 7, 2017 to State
Governor Susana Martinez signed HB260, which provides important pathways for patient access to biologic medications, while also creating much needed safety rules that include a mandate that pharmacists must communicate to physicians about a biosimilar substitution within 5 days of its dispensing.
Kansas’ Bill for Biosimilars Awaits the Governor’s Signature
posted: April 4, 2017 to State
In Kansas, HB2055 has reached approval in the House and Senate and awaits the Governor’s signature. This bill provides important pathways for access to biologic medications.
Formulary Changes Hurt the Patients Most
posted: March 29, 2017 to CSRO News, Federal
Rheumatologists are at the forefront of innovative treatments for patients with complex autoimmune diseases such as rheumatoid arthritis.
New Legislation Could Shine a Light on the Elusive World of Prescription Drug Pricing
posted: March 27, 2017 to Federal
Ever-increasing drug prices have recently been at the forefront of the healthcare debate in America, and a new bill introduced in Congress last week may be the important first step in shedding light on the intermediaries who play a huge yet largely unnoticed role in drug pricing: Pharmacy Benefit Managers (PBMs).
Biosimilars Legislative Status Update — March 2017
posted: March 21, 2017 to State
Montana and Iowa recently joined the now 28 states to provide pathways for access to Biosimilars, and create much needed patient safety rules, including guidelines for dispensing pharmacists to communicate to physicians about biosimilar substitutions.
CSRO Submits Interchangeability Comments to FDA
posted: March 21, 2017 to CSRO News, Federal
As patient and physician advocates, we have been deeply involved in the debate surrounding implementation of the Biologics Price Competition and Innovation Act (BPCIA).
Step Therapy Legislative Update: Iowa Fail First Advocacy Day
posted: March 17, 2017 to State
Like multiple other states across the country, Iowa is tackling step therapy reform this year and is making great progress as efforts continue to move forward.
State Advocacy Spotlight: Step Therapy in New Mexico and Texas
posted: March 15, 2017 to State
It was another active week for step therapy legislation across the country; here are some highlights from New Mexico and Texas.
Iowa Enacts Legislation for Biosimilars
posted: March 14, 2017 to State
Iowa joined the 27 other states, including Puerto Rico, that have passed legislation to provide pathways for access to Biosimilars, and create much needed patient safety rules, including a guideline for pharmacists to communicate to physicians about a Biosimilar substitution within 5 business days of its dispensing.
In the News: When Critical Medications Leave the Formulary, Patients Can Be Devastated
posted: March 7, 2017 to CSRO News, State
At the beginning of this new year, a worrisome change took effect for patients with chronic illnesses across Minnesota. Many patients have just become aware that their current medical treatment will no longer be covered, which may have a serious impact on their health in 2017 and lead to consequences beyond.
The CSRO Holds Another Successful Fellows Conference
posted: March 1, 2017 to CSRO News
On February 18, the CSRO held another successful Fellows Conference, complete with a host of interesting presentations on pertinent topics.
Montana Passes Legislation for Biosimilars
posted: February 24, 2017 to State
The State of Montana joined the 26 other states, including Puerto Rico, that have now passed legislation to provide pathways for access to Biosimilars, and create much needed patient safety rules...
State Advocacy Spotlight: Biosimilars in Nebraska
posted: February 15, 2017 to State
Attempting to join the 26 other states that have enacted laws for Biosimilars and their dispensing, Nebraska’s Unicameral Legislature will hear LB481 in the Health and Human Services Committee.
State Advocacy Spotlight: Step Therapy in Oregon
posted: February 13, 2017 to State
Like multiple other states across the country, Oregon is tackling step therapy reform this year and has made great progress so far.
CSRO Policy Update, January 2017, Issue 4
posted: February 13, 2017 to CSRO News, Policy Update
In this issue: President’s Message; Biosimilar Advocacy Update; New CSRO Advocacy Initiative; Step Therapy Advocacy Update; Non-Medical Switching Legislation; Save the Date
CSRO Supports Biosimilars Legislation in Multiple States this Week
posted: February 10, 2017 to State
Legislation is being unveiled across the country to address Biosimilars, and create the pathways needed for pharmacists to dispense Biosimilar substitutions to patients, while communicating the substitution with the patient’s physician in a timely manner.
Step Therapy Legislative Update
posted: February 10, 2017 to State
It was another active week for step therapy legislation across the country; here are some highlights from Ohio and Iowa.
CSRO Supports Step Therapy Legislation in Utah, Texas, and Iowa
posted: February 3, 2017 to CSRO News, State
This week was a big one for step therapy legislation, which moved forward in three key states.
Step Therapy Legislation Introduced in Iowa is Moving Forward to Full House Committee for Review
posted: February 1, 2017 to State
A step therapy bill in Iowa received unanimous support from a House subcommittee will now be heard by the full House committee in the coming weeks.