Updates from Capitol Hill

Help Prevent Medicare Physician Fee Schedule Cuts

CSRO recently launched a grassroots advocacy campaign related to the looming reimbursement reductions in the Medicare Physician Fee Schedule (MPFS), which total almost 8.5%. That number consists of two separate cuts: a 4% PAYGO sequestration and an almost 4.5% reduction to the MPFS. 


There seems to be bipartisan agreement that the 4% sequestration must be averted, but the fate of the almost 4.5% MPFS cut is less clear. Although Congress is highly unlikely to let a cut of that magnitude go into effect for physicians, congressional leadership is negotiating whether to avert some portion of it, rather than the entire amount. Fortunately, legislation has been introduced in the House and Senate that would avert the almost 4.5% entirely, which serves as a nice “stake in the ground” in these discussions.


CSRO’s opportunity for action urges Congress to avert the cumulative 8.5% reduction in its entirety, and your support is needed. Make your voice heard and join us in urging Congress to act on this bill by taking action today!

TAKE ACTION

Educating Medicare Beneficiaries about Utilization Management

Last month, Senators Maggie Hassan (D-NH) and Roger Marshall, M.D. (R-KS) introduced the Medicare & You Handbook Improvement Act (S.5117), which would improve the information that Medicare beneficiaries receive during the annual open enrollment period. If enacted, the bill would require the Centers for Medicare and Medicaid Services (CMS) to explain the different kinds of utilization management to beneficiaries, as well as inform beneficiaries how they can find out which of these tactics apply in the various Medicare Advantage (MA) or Part D plans they might be considering enrolling in.

 

Critically, CMS would also be required to explain to beneficiaries that, if they choose to leave traditional Medicare for MA, they may be limited in their supplemental coverage, should they decide to switch back to traditional Medicare at a later time. (Many beneficiaries are unaware of this when they first enroll in MA and only become aware when they try to return to traditional Medicare but can no longer obtain wraparound coverage, which is why this is a critical piece of information, particularly for beneficiaries with chronic, high-cost illnesses, including rheumatoid arthritis.)

 

Given that the Senate bill was introduced so late in the year, it is unlikely that it will become law before the Congress adjourns. However, both of the lead sponsors will return in the next Congress and hold memberships on the Committees with jurisdiction over healthcare issues. CSRO will remain engaged with these offices in the new Congress on this and other efforts related to utilization management, and will continue to keep you updated.

Addressing Drug Administration Challenges: CSRO Leads Multispecialty Coalition

Next week, CSRO and a group of clinical specialties and infusion providers will meet with the Centers for Medicare and Medicaid Services (CMS) to discuss challenges with policies that complicate and hinder access to drug administration services in the office setting.

 

CSRO established the multispecialty collaborative in response to feedback from the agency that is responsible for setting Medicare payment and policies associated with the delivery of medications in the office. The groups’ chief concerns relate to “down coding” of complex medications and the Self-Administered Drug (SAD) Exclusion List, which will be the focus of the physician-led conversation with senior CMS staff.  

Mark Your Calendar: CSRO's 2023 Events

CSRO's Fellows Conference: March 10-11, 2023

Share our latest email with the fellows in your network so they can be a part of CSRO's 2023 Fellows Conference, which includes:

  • Insights from Dr. James Dahle, The White Coat Investor, on physician-specific personal financial management
  • Sessions on key topics like physician employment and contracts, coding, and the realities of private practice
  • A stipend for rheumatology fellows, residents pursuing a rheumatology fellowship, and rheumatologists with three or less years of experience to underwrite the cost of travel and lodging expenses for this event


CSRO's National Town Hall: January 25, 2023

2023 marks 20 years of advocacy for CSRO! Join us virtually for a National Town Hall to learn updates on our advocacy work and share about issues impacting you or your practice.


CSRO's Advocacy Conference: August 25-27, 2023

Mark your calendars to join us in Austin for CSRO's Advocacy Conference and celebration of our 20th Anniversary! 

Help Make a Difference: Donate Today


Advocacy can have a tremendous impact on a patient's access to care, disease management options and overall quality of life, and it has been the cornerstone of CSRO's mission since we were founded in 2003.


One father has witnessed that impact firsthand as CSRO successfully advocated for his son’s continued access to effective treatment for juvenile arthritis. To express his gratitude, he donates to CSRO to help ensure others benefit from our commitment to achieving the highest quality of care for patients nationwide.


Join him in supporting advocacy for critical rheumatological care by making a tax-deductible donation today give now!

Donate Today

Advocating for You: Alliance of Specialty Medicine Virtual Advocacy Day

Yesterday, December 8, the Alliance of Specialty Medicine (ASM) hosted a Virtual Advocacy Day.


As a long-time member of ASM, CSRO leadership from around the country assembled with physicians from 14 other medical specialties to voice their policy concerns with congressional leaders on Capitol Hill.

Legislation Around the Country

What's Happening in the States

CSRO tracks legislative activity relevant to the rheumatology community and their patients – click here to view a full status report.


Be sure to check out our interactive legislative map tool for additional information about current policy in your state.

CSRO Resources for You

  • Payer Issues Reporting Form
  • Request assistance with any payer relation issues that may be impacting your patients or office.
  • 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.
  • Action Center
  • Use CSRO's Voter-Voice engagement platform to easily communicate and engage directly with your elected officials.
  • Policy Correspondence Archive
  • Easily access all of CSRO’s policy letters submitted to payers, state, and federal governments as an informational resource.
  • Career Center
  • Locate the perfect fit whether you're looking for new career opportunities or trying to find the right candidate.


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.

2023 marks CSRO's 20th Anniversary! Stay tuned for more details about how you can join us in celebrating our two decades of serving as the voice for rheumatology. Have memories of CSRO's founding? Email info@csro.info to share your story or photo with us.

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