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2020-12-16 Most Favored Nation Rule - CSRO Comments and Resources for Rheumatologists

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Most Favored Nation Rule - CSRO Comments and Resources for Rheumatologists

Posted: December 18, 2020

Recently, the Center for Medicare and Medicaid Services (CMS) released an interim final rule implementing the “Most Favored Nation” (MFN) pricing scheme for Medicare Part B drugs. There are many questions about what the new rule means for rheumatology and Medicare beneficiaries with rheumatologic conditions.

There is also a great degree of concern amongst the rheumatology community. The rule is set to go into effect on January 1st of the new year, and the rheumatology community must familiarize and prepare itself for the new operating environment.

To answer some of the questions that the rheumatology community has about the contents of the new rule, CSRO has made a presentation outlining the new proposal and how rheumatology will be affected publicly available. How will new reimbursement rates be calculated? Which rheumatology drugs will be included? How will biosimilars be treated? Who must participate? What’s the bottom line for practices? The presentation walks through answers to these questions and more. Click the link below to access the presentation. If questions remain, you may direct them to info@csro.info.

Those reading the presentation would be rightfully concerned about the new rule and its pending implementation on January 1st. CSRO shares those concerns, and submitted comments opposing implementation of the new rule. To read CSRO’s full comments on behalf of rheumatologists, click the link below.

Although CSRO believes its comments will prove impactful, the comment period for the MFN rule ends after its effective implementation date. Because of this discrepancy, CSRO still needs the rheumatology community’s help. We encourage rheumatologists to join with CSRO and other stakeholders in pushing for Congress to oppose the rule.

Rheumatologists can do so by visiting the CSRO action center to send a letter to their Senators and Representative. Doing so can be completed in just a few clicks, however, CSRO does encourage personalization of the provided message. Personalized messages have a higher degree of visibility with lawmakers. Rheumatologists can also urge their colleagues to contact Congress using a toolkit developed in coordination with the Community Oncology Alliance (COA). This toolkit provides background on the rule, and information for rheumatologists to contact legislators.

Finally, rheumatologists can get their patients involved as well. CSRO has developed a patient toolkit for offices, and a digital engagement geared towards patients for those interested in getting involved.


Read the Presentation

See CSRO’s Comments

View the Physician Toolkit

View the Patient Toolkit

Patients Take Action

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