Rheumatology Advocates Armed to Take Action
Posted: September 25, 2021
CSRO state society member advocates and leadership from around the country gathered virtually earlier this month at the State Society Advocacy Conference (SSAC) to learn about the latest state and federal policy issues impacting the rheumatology community. The online event hosted over 85 attendees and provided policy education from some of the most highly respected advocates in the specialty health care arena.
Dr. Madelaine Feldman, President of the CSRO, kicked the meeting off by highlighting CSRO efforts that have led to the policy discussions at this year’s SSAC before introducing the first session, which gave an overview of the federal landscape and the impact of current polices on rheumatologists and their patients. Dr. Aaron Broadwell, a CSRO board member and private practice physician from Louisiana, drove the discussion that focused on the latest health policies by Congress and the U.S. Centers for Medicare & Medicaid Services (CMS).
Pharmacy Benefits Managers (PBMs) quickly became the focus of the meeting after the federal panel concluded. Attendees first heard from Jonathan Levitt, a co-founder of the Healthcare law firm Frier Levitt. Mr. Levitt reviewed the PBM rebate game and spoke to how the U.S. Supreme Court 8-0 decision in favor of Rutledge (Rutledge v. PCMA) would impact state laws regarding the Employee Retirement Income Security Act of 1974 (ERISA).
Ted Okon, the Executive Director for the Community Oncology Alliance (COA), continued with the PBM theme by discussing how they impact oncology patients. Mr. Okon expressed the importance of cross-specialty collaboration as specialties continue to battle bad PBM practices. The PBM discussion was concluded by the Karry La Violette, Senior Vice President of Government Affairs and Director of the Advocacy Center for the National Community Pharmacists Association (NCPA). She reviewed the current impact of Direct and Indirect Remuneration (DIR) fees in the NCPA lawsuit against PBMs.
CSRO’s other focus was utilization management (UM) issues in the states, which includes step therapy/fail first protocols, non-medical switching, prior authorization, accumulator adjustment programs, and other UM practices. Dr. Bob Levin, CSRO board member, helped lead the discussion on these issues with Tennessee State Senator Shane Reeves, who has been a champion of patient access issues within his own state.
The program concluded with comments from the Executive Vice President of the American College of Rheumatology (ACR), Steve Echard, followed by the keynote speaker, Professor Lawrence Van Horn, a leading expert and researcher on health care management and economics at Vanderbilt University. Mr. Echard spoke about the need for collaboration between all rheumatology organizations. Professor Van Horn provided a forecast for the economic outlook for rheumatologists in America, which included insights into a credit score like evaluation by payers for malpractice lawsuits.
To wrap up the day, CSRO leadership gave a heartfelt and unscripted tribute to outgoing Board members and CSRO founders Michael Schweitz, MD and Greg Schimizzi, MD, in recognition of the significant role they played in the formation and ongoing successes of CSRO. View a slideshow of Dr. Schweitz and Dr. Schimizzi throughout the years here.
The entire CSRO SSAC program can be accessed and watched online by visiting CSRO's Education Library. To learn about other upcoming events from CSRO, visit our website; inquiries about the SSAC, other events and resources, or CSRO in general can be directed to info@csro.info.
