Advocacy: CSRO President Testifies in Support of Wisconsin White Bagging Legislation
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Following Louisiana's example, a number of states are beginning to take a look at prohibiting payers from mandating the use of white bagging for provider administered drugs. CSRO has been working to support these bills, which will help to ensure that rheumatology practices can continue to buy and bill under certain state- regulated plans.
Wisconsin is one such state considering legislation this year, and SB 753 was heard by the Senate Insurance, Licensing, and Forestry Committee on January 20. CSRO President Madelaine Feldman, MD, FACR traveled to Madison to testify in support of the legislation and was joined by Nilsa Cruz, a Wisconsin practice manager involved with both the Wisconsin Rheumatology Association and CSRO (both pictured above). While much of the testimony that day focused on a battle currently being waged between hospitals and health plans, Dr. Feldman and Nilsa's testimony focused on the advantages that independent practices bring to the table, and why preventing payers from doing away with buy and bill was important for sustaining their continued viability.
The hearing was informational only, and a potential vote would be scheduled for a later date. The Assembly side companion legislation will likely be heard in its respective committee sometime in February.
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Opportunity for Action in Wisconsin |
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If you are a Wisconsin resident and have not already done so, we encourage you to join CSRO is asking your state lawmakers to support SB 753. Take action by sending a message to your legislators today! |
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Marketplace Plans: Rheumatologists Support Efforts to Prohibit Discriminatory Benefit Design, Improve Network Adequacy
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Through its coalition partner, the Alliance of Specialty Medicine (“Alliance”), CSRO urged the Centers for Medicare and Medicaid Services (CMS) to prohibit discrimination in Marketplace plans and require issuers to use clinical evidence in benefit design decisions.
As outlined in the 2023 Notice of Benefit and Payment Parameters (“Payment Notice”), CMS has noticed that issuers have used adverse tiering to limit access to prescription drugs commonly needed for patients with chronic health conditions. In comments, CSRO and the Alliance explained that “formulary decisions are almost exclusively influenced by financial considerations rather than clinical data, especially when it comes to specialty medicines” and significant impacts patients that rely on these medicines for multiple conditions, including rheumatoid arthritis. To address this challenge, CSRO urged CMS to finalize its proposal that would require clinical evidence as the basis for nondiscriminatory benefit design.
CSRO and the Alliance also urged CMS to finalize proposals aimed at ensuring adequate provider networks in Marketplace plans, making a number of recommendations to the agency to combat the problem of narrow provider networks.
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Spotlight: CSRO's Rheum for Action Column
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Could stopping ‘thousand cuts’ by insurers and Pharmacy Benefit Managers (PBMs) help rheumatology’s workforce shortage? This is what CSRO President Madelaine Feldman, MD, FACR discusses in the latest edition of Rheum for Action, CSRO's advocacy column produced in partnership with Rheumatology News.
Read more about the frustrations rheumatologists face over having the doctor-patient shared decision-making taken out of their hands and given to the insurance companies and their PBMs (PDF available here).
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February 2: Rheumatoid Awareness Day
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This Wednesday, February 2, is Rheumatoid Awareness Day. Follow CSRO on social media for ways you can help raise awareness and take action.
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Legislation Around the Country
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ICYMI: Opportunity For Action in Your State
The following states have active legislation that need your support - make your voice heard today:
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What's Happening in the States
CSRO tracks legislative activity relevant to the rheumatology community and their patients. Check out the list below to see the status of CSRO priority bills from the past two weeks. For a full status report on all the bills CSRO tracks, click here.
Be sure to check out our interactive legislative map tool for additional information about current policy in your state. Plus, don't forget to add your state to your email profile here to receive state-specific updates and action alerts via email. |
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ARIZONA
White Bagging
- SB 1161: Reported favorably by Senate Health and Human Services Committee
ILLINOIS
White Bagging
- HB 4774: Referred to Rules Committee
- SB 3924: Referred to Assignments
INDIANA
Rebate Pass Through
- SB 88: Approved by Committee with amendments
IOWA
Accumulator Programs
- SF 2092: Introduced and referred to Commerce Committee
Non-medical Switching
- HF 656: Subcommittee recommends passage
- SF 2016: Tabled until future meeting by subcommittee
Rebate Pass Through
- SF 2092: Introduced and referred to Commerce Committee
- HSB 623: Subcommittee meeting scheduled for February 1, 2022
KENTUCKY
Prior Authorization “Gold Card”
- HB 343: Introduced and referred to Committee on Committees
MAINE
Accumulator Programs
- LD 1783: Public hearing held, work session scheduled
MISSISSIPPI
Accumulator Programs
- HB 880: Referred to Insurance Committee
- SB 2470: Referred to Insurance Committee
Rebate Pass Through
- SB 814: Referred to Insurance and Banking Committee
White Bagging
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NEBRASKA
Accumulator Programs
- LB 718: Notice of hearing for February 28, 2022
- LB 767: Referred to Banking, Commerce, and Insurance Committee
White Bagging
- LB 943: Notice of hearing scheduled for February 15, 2022
NEW HAMPSHIRE
Rebate Pass Through
- HB 1580: Scheduled for Public hearing on February 2, 2022
NEW JERSEY
Step Therapy
- S 308: Referred to Senate Commerce Committee
OHIO
White-bagging
- HB 451: Sponsor hearing held January 26, 2022
OKLAHOMA
Rebate Pass Through
- SB 1324: Referred to Retirement and Insurance Committee
- HB 3493: Introduced
- HB 3492: Introduced
- HB 4087: Introduced
UTAH
Accumulator Programs
WASHINGTON
Accumulator Programs
- SB 5610: Passed to rules committee for second reading
Rebate Pass Through
- SB 5888: Scheduled for public hearing on January 28, 2022
WEST VIRGINIA
White Bagging
- HB 4263: House Health and Human Resources Committee Recommends do pass with amendments
WISCONSIN
White-Bagging
- SB 753: Informational hearing held
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Registration Now Open!
Save the Date!
Find all of CSRO's event dates by visiting our Upcoming Events page, and check out past events and webinars in our Library.
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CSRO is a 501c3 nonprofit organization dedicated to ensuring access to the highest quality care for the management of rheumatologic diseases - donate today.
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