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In the News

Read all about what is happening with CSRO. To view our Bi-Weekly Updates, click here. To view the latest editions of Rheum for Action, click here.


CSRO in the News: 2024

 

Alternative Funding Programs: What Employers Need to Know

posted: February 20, 2024 to CSRO News

CSRO Vice President of Advocacy & Government Affairs Dr. Madelaine Feldman joins nine other co-authors in this white paper that explains the unintended consequences of alternative funding programs, raises attention to the risks for employers and employees, and provides more ethical cost-containment strategies for employer-sponsored health plans.

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CSRO Policy Update: Winter 2024

posted: February 20, 2024 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.

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Congress Can Fix the Broken PBM Industry

posted: February 14, 2024 to CSRO News

Congress is in the process of negotiating a set of bipartisan health policies, including pharmacy benefit manager (PBM) reform. On the table for inclusion are two policies that will provide immediate relief for patients in the form of reduced out-of-pocket costs for drugs.

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Health Care Antitrust Weekly: Vol. 12 No. 42

posted: January 24, 2024 to CSRO News

Klobuchar Presses Drugmakers to De-list FTC-Disputed Patents by End of Month; FTC Responds to Motions to Dismiss in Case Against U.S. Anesthesia Partners and Welsh Carson; Updates on Encompass Health, iRythm, Corcept

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Letters: Step therapy rules need reform so patients can access treatment

posted: January 9, 2024 to CSRO News

For years, I’ve watched the barriers my patients face in accessing the treatments I prescribe continue to grow. That is part of the reason I and many other health care professionals and patients advocated vociferously back in 2020 to pass updated legislation in Louisiana that addressed one of the most daunting barriers that can be placed on prescribed treatments — a process called "step therapy."

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Addressing the real culprits of rising drug prices | Opinion

posted: January 7, 2024 to CSRO News

Pharmacy benefit managers serve as middlemen between pharmacists and insurance plans. They are often controlled by large insurance companies, like Express Scripts, which is owned by Cigna, and are thus capable of pricing small independent pharmacies out of business.

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FDA Approves Florida's Proposal to Import Prescription Drugs From Canada

posted: January 5, 2024 to CSRO News

The FDA on Friday approved a plan by the state of Florida to allow direct importation to the state of drugs from Canada, many of which are expected to be at a much lower cost than the same drugs procured in the U.S.

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CSRO in the News: 2023

 

Final 2024 Medicare PFS Boosts Rheumatology Pool by 2%

posted: November 10, 2023 to CSRO News

On November 2, CMS released the Calendar Year (CY) 2024 Medicare Physician Fee Schedule Final Rule, announcing a conversion factor of $32.7442 – down 3.37% or $1.15 from the CY 2023 MPFS conversion factor of $33.89.

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Underwater with Biosimilars: What You Should Know

posted: September 27, 2023 to CSRO News

CSRO continues to hear from practices around the country about biosimilars being “underwater” in terms of acquisition cost versus reimbursement level. Although this issue first emerged with regard to Inflectra, it seems to exist for other biosimilars now as well.

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CSRO 2023 State Society Advocacy Conference: In Review

posted: September 1, 2023 to CSRO News

State rheumatology leaders from across the country gathered in Austin, Texas this past weekend for the Coalition of State Rheumatology Organizations (CSRO) Advocacy Conference and 20th Anniversary Celebration. Attendees learned about the latest advocacy issues of impact to the rheumatology community.

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Reform of ‘Insurance middlemen’ is overdue for NC families

posted: August 3, 2023 to CSRO News

"Helping North Carolinians navigate the complexities of our health care system is a significant part of my career as a physician – and as the parent of a child with a chronic illness, it’s also a very personal daily battle" - hear more from CSRO Board Member Dr. Firas Kassab.

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CSRO Policy Update: Summer 2023

posted: August 3, 2023 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.

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The ‘great American switching experiment’: Cyltezo debut ushers in interchangeable era

posted: July 24, 2023 to CSRO News

The hotly debated topic of interchangeability between biologics and biosimilars has officially leapt from the hypothetical realm to clinical practice, ushering in a new era of therapy switching in rheumatology.

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Proposal to Cap Part B Pay on Some Drugs Draws Opposition

posted: June 20, 2023 to CSRO News

An influential panel proposed capping Medicare Part B pay for some drugs, arguing this would remove financial incentives to use more costly medicines when there are less expensive equivalents.

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Opinion: Health insurance too often fails to make the grade

posted: June 15, 2023 to CSRO News

Movies and TV programs showing insurance companies denying care to critically ill patients to save money are thought to be episodic in nature — exceptions rather than the rule.

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Permission to Prescribe: Physicians allege insurance intermediaries, red tape are driving decisions about care, with patients paying the price

posted: June 12, 2023 to CSRO News

Benefit managers insist they are lowering costs and improving outcomes, but critics say these ‘middlemen’ have too much control.

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Coherus works with Mark Cuban to sell biosimilar Humira at steep discounts

posted: June 1, 2023 to CSRO News

In a bold move, Coherus BioSciences plans to sell a biosimilar version of Humira — one of the world’s best-selling medicines — at a steep discount, and will work with Mark Cuban’s generic drug company to make the medicine available directly to consumers for even less.

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Letters: Government must address equity in health care

posted: May 2, 2023 to CSRO News

CSRO's Vice President of Advocacy and Government Affairs discusses improving access and healthy equity in Louisiana.

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Bipartisan Senate Plan Would Regulate PBM Compensation, Target ‘Unfair’ Drug Price Hikes

posted: April 24, 2023 to CSRO News

Leaders of the U.S. Senate Finance Committee have introduced a bipartisan framework aimed at regulating pharmacy benefit managers as well as to “modernize and enhance” federal prescription drug programs, according to a press release.

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Rheumatology Fellows Learn About Career Opportunities

posted: March 17, 2023 to CSRO News

Medscape's highlight of CSRO's 2023 Fellows Conference: Various career paths open to newly board-certified rheumatologists — and some of the pros and cons for each — were explored at the recent 2023 Fellows Conference of the Coalition for State Rheumatology Organizations (CSRO).

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New Rheumatologists Need Insurance Awareness to Give Best Care

posted: March 17, 2023 to CSRO News

Medscape's highlight of CSRO's 2023 Fellows Conference: New rheumatologists face a wide range of significant challenges brought on by the increasing complexity of insurance billing and rapid changes to managed care practices, especially techniques of utilization management and pharmacy benefit managers (PBMs).

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CSRO Policy Update: Winter 2023

posted: February 10, 2023 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.

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Amgen’s acquisition of Horizon could have ‘downstream effects’ in rheumatology

posted: February 2, 2023 to CSRO News

The recent acquisition of Horizon Therapeutics by Amgen continues a trend in medical finance that may have implications for both rheumatologists and their patients.

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Iowa health plans don’t provide stable care for chronic illness

posted: January 29, 2023 to CSRO News

CSRO Board Member Dr. Michael Brooks shares why Iowa legislators should put an end to non-medical switching.

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CSRO in the News: 2022

 

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).

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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.

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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.

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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.

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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.

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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.

READ MORE ⇒

CSRO in the News: 2021

 

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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

READ MORE ⇒

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.

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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.

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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.

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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).

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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. The 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.

READ MORE ⇒

CSRO in the News: 2020-2017

To view the CSRO news archive, click here

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