Congress Passes Continuing Resolution to Fund the Government

Congress passed a Continuing Resolution that funds the federal government through March 14 after negotiations were initially derailed last week when President-elect Trump and Elon Musk intervened. The initial bipartisan package included several CSRO priorities that were unfortunately stripped from the final package, including:

• 2.5% adjustment to the Medicare Physician Fee Schedule
• Delinking for Medicare Part D – the PBM can only receive payment for bona fide services. This is a flat dollar amount and cannot fluctuate based on a percentage of rebates, concessions or formulary placement
• Rebate Pass Through for Medicare Part D and ERISA – 100% of rebates, discounts and concessions need to go back to the health plan sponsor and cannot be held by the PBM
• Transparency – PBM reporting to the Secretary and to the health plans, including information on pricing, PBM vertical integration with pharmacies

Following objections by Trump and Musk, the package was ultimately paired back, passing the House 366-34 and the Senate 85-11. Incoming GOP Doctors’ Caucus co-chair Greg Murphy, MD (R-N.C.) confirmed that he received assurances from the Trump transition team that the next government funding package will include a measure to address cuts to the physician fee schedule, and that the eventual doc fix will apply retrospectively.

While there were significant efforts to include the Improving Seniors’ Timely Access to Care Act (H.R. 8702/S. 4532), which would streamline Medicare Advantage prior authorizations for medical services and Part B medications, the bill also failed to be included in the package. 

MedPAC Recommends CY 2026 Physician Payment Update of MEI - 1%

The Medicare Payment Advisory Commission (MedPAC) discussed draft payment update recommendations for 2026 during its meeting on December 12–13, 2024. These recommendations include updating Medicare base payments for physicians and other health professional services by the projected increase in the Medicare Economic Index (MEI) minus 1%. MedPAC plans to vote on these recommendations at its public meeting scheduled for January 16–17, 2025. Once approved, the final recommendations will be included in MedPAC's March 2025 Report to the Congress.

A new resource focused on the Merit-based Incentive Payment System (MIPS), with additional detail on the new Rheumatoid Arthritis (RA) cost measure, has been posted on CSRO’s website. This resource will provide helpful information for rheumatology practices and other interested stakeholders on MIPS participation for the CY 2025 Performance Period/2027 Payment Year.

Encourage rheumatology fellows to attend CSRO's 2025 Fellows Conference, an annual event curated by rheumatologists specifically for fellows to help them prepare for their future roles as physicians.

This professional development opportunity is free and CSRO provides expense reimbursement for rheumatology fellows, residents planning to pursue a rheumatology fellowship, and practitioners 1-3 years out of fellowship who have not attended the event before.

Registration is open through Monday, January 20 – share this information with the fellows in your network so they can be a part of this can't-miss event!

Support CSRO's Ongoing Advocacy Work:  Give a Gift Today

CSRO is a 501(c)3 nonprofit organization that has remained dedicated to ensuring access to the highest quality care for over 20 years. Advocacy is the cornerstone of CSRO’s mission, and we remain at the forefront of state and federal efforts to grant access, affordability, and relief for physicians, patients, and practices.

This past year, CSRO has met directly with lawmakers and regulators, supplied on-the-ground resources throughout the states, supported negotiations on legislation and helped draft model language, sent letters of support and requests for action, and generated grassroots advocacy campaigns – all in an effort to aid rheumatologists in protecting their patients and their livelihood.

Our work continues, and we ask you to support our advocacy efforts by making a donation to help ensure access to critical rheumatological care today.

LA: CSRO Offers Recommendations to Task Force Report

Following months of testimony from experts, the Louisiana Alternative Funding Programs (AFPs) Task Force produced a draft report on its findings, which it will ultimately submit to the state legislature per legislative mandate. Madelaine Feldman, MD, who serves on the Task Force on behalf of the CSRO and Rheumatology Alliance of Louisiana, provided substantive recommendations to the report to more clearly articulate the egregious practices of AFPs and to better protect patients from their predatory business practices. The Task Force is slated to submit its report to the legislature before December 31, 2024.

MI: CSRO and MRS Voice Concerns over 340B Program

In letters to the Michigan Senate and House, CSRO and the Michigan Rheumatim Society (MRS) shared concerns regarding S.1179, which would allow for significant growth in the 340B drug discount program and fails to incorporate guardrails that ensure patient access to discounted medications. In the final weeks of the state session, the legislature attempted to force this bill through the legislative process. However, the bill failed to advance and died upon adjournment of the legislature.

Learn more about the 340B drug discount program through CSRO’s explanatory statement and policy principles, which offer recommendations on ways to strengthen the 340B drug discount program and better protect patient access.

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, and click here to view a full status report of CSRO priority bills.

Be sure to check out our interactive legislative map tool for additional details.

New Jersey

Accumulators

• S3818: Reported out of Senate Commerce Committee

Biomarker Testing

• A4163: Reported out of Assembly Appropriations Committee

Michigan

340B

• S.1179: Passed the Senate, Died upon Adjournment

CSRO is at the forefront of advocacy efforts around the legislation & regulation governing rheumatology treatments - work that isn't possible without the support of our corporate partners. We thank you for your help throughout 2024!

AbbVie

Altus Biologics

American Rheumatology Network

Amgen

ANI Pharmaceuticals, Inc.

AQTUAL

Articularis Healthcare

AstraZeneca

Aurinia

Bendcare

Boehringer Ingelheim

Bristol Myers Squibb

Genentech

GSK

Ipsen

Johnson & Johnson

Lilly

Mallinckrodt

Novartis

Pfizer

PhRMA

Sanofi

Scipher Medicine

SetPoint Medical

UCB

Zenas BioPharma

Business of Rheumatology: January 29, 2024

CSRO's virtual seminar series to help support rheumatology practices in building and strengthening their business.

CSRO Town Hall: February 10, 2024

Kick off the year with CSRO at this virtual meeting as we provide updates on our state policy priority issues and a 2025 legislative forecast.

CSRO Fellows Conference: February 21-23, 2025

An annual event to help rheumatology fellows prepare for their future roles as practicing rheumatologists.

CSRO Advocacy Conference: September 12-14, 2025

Mark your calendars to join us in Dallas, Texas, for CSRO's annual Advocacy Conference! 

Action Center

Use CSRO's convenient online platform to easily find out who your elected officials are and engage with them directly.

Advocacy Council

Amplify your voice by assembling with other like-minded individuals to enhance CSRO’s advocacy initiatives.

Career Center

Locate the perfect fit whether you're looking for new career opportunities or trying to find the right candidate.

Explanatory Statement: “Underwater” Biosimilars

To aid in addressing the issue of "underwater" biosimilars with payers, CSRO has created a document to illustrate the extent of the problem.

Legislative Map Tool

Find your state on our interactive map tool to learn about current or proposed policy and ways you can take action to make an impact.

Payer Issues Reporting Form

Request assistance with any payer relation issues that may be impacting your patients or office.

Policy Correspondence

Easily access all of CSRO’s policy letters submitted to payers, state, and federal governments as an informational resource.

Rheum for Action

Learn about the latest advocacy issues in CSRO's advocacy column authored by Dr. Madelaine Feldman and produced in partnership with Rheumatology News.

Step Therapy Cover Sheets

Review CSRO's state-specific step therapy materials that help guide practices in gaining an exemption from step therapy protocols.

Questions?

Please visit the CSRO website for other news and updates, and do not hesitate to contact us with any questions at info@csro.info.