February 2011
The essential resource for your practice
Volume XXI, Number 2

AUA Health Policy Committee Fall Meetings

The AUA Health Policy Council, chaired by Steven M. Schlossberg, MD, MBA, gathered in mid-November to hold its fall meeting at AUA Headquarters in Linthicum, MD.@blurbend The bulk of the meeting focused on updates from the five health policy-related committees that report to the HPC.

The committees include:

Click on the links above for full meeting summaries.

Jeffrey M. Frankel, MD; Jay A. Motola, MD; and Deborah Lightner, MD, participate in the Health Policy Council meeting.

Jeffrey E. Kaufman, MD, member of both the Legislative Affairs Committee and the Health Policy Council, speaks to Sarah Elder, Senior Manager of Annual Fund and Individual Giving for the AUA Foundation.

Howard M. Snyder III, MD; Martin K. Dineen, MD; Roger Dmochowski, MD; and Thomas P. Cooper, MD, attend the Coding & Reimbursement Committee meeting.

Additional discussions included:

  • A presentation, titled “Medicare Utilization Trends for Common Urologic Diagnostic Imaging Procedures,” given by AUA Manager of Research & Data Analysis Lu Lu Kuang, PhD. Dr. Kuang’s analysis of Medicare’s raw data debunked the common misconception of urology’s overutilization of imaging.
  • A discussion, led by Johannes W.G. Vieweg, MD, chair of the AUA Foundation Research Council, on possible collaborative efforts. The Research Council is interested in expanding its sources of research funding by approaching various federal agencies and departments. Health Policy staff and volunteer physicians already have relations with a variety of federal agencies; therefore, working together to promote a combined, integrated agenda would be advantageous for both the HPC and the Research Council.
  • A dialogue led by Dr. Schlossberg on accountable care organizations (ACOs). The Affordable Care Act of 2010 calls for the creation of ACOs as a way to improve healthcare delivery and reduce costs. However, there are many unknowns about the program and facets that have yet to be determined. Dr. Schlossberg noted many of these questions and uncertainties, and advised HPC members to be mindful during the process to develop the ACO program.
Table of Contents


Coding Corner:

What is the proper way to code a transurethral resection of bladder neck?

James C. Ulchaker, MD, Named 2011-2012 Gallagher Health Policy Scholar

The Gallagher Health Policy Scholar Program Selection Committee is pleased to announce the selection of James Ulchaker, MD, as the 2011-2012 Gallagher Health Policy Scholar. He is the fifth urologist to receive this honor.

The Gallagher Health Policy Scholar Program, created in honor of former AUA Executive Director G. James Gallagher, is designed to train the next generation of urologists for leadership positions in health policy. Scholars spend a full year engaged in critical seminars, conferences and meetings at the national level; receive mentoring from senior AUA physicians; and participate in a week-long health policy seminar for surgeons at Brandeis University, sponsored by the American College of Surgeons. Scholars also engage in other activities that ensure their immersion in and understanding of health policy issues important to urology.@blurbend

Dr. Ulchaker graduated from Baldwin Wallace College and Case Western University School of Medicine, and completed his residency at the Cleveland Clinic Foundation. He has subsequently been on the Cleveland Clinic’s staff in the section of Urologic Oncology/Prostate Center for 14 years. The majority of his research has been in the field of new technologies associated with benign prostatic hyperplasia and prostate cancer, as well as biodegradable urethral stents and bladder cancer tumor markers.

Additionally, Dr. Ulchaker has been active in organized urology. He has served as president of both the Cleveland Urological Society and the Ohio Urological Society, as well as chair of the AUA’s Young Urologists Committee. He currently serves as one of the AUA North Central Section’s representatives to the AUA’s Health Policy Council and as vice chair of the AUA Legislative Affairs Committee.

The Gallagher Health Policy Scholar Program Selection Committee is chaired by AUA Health Policy Chair Steven M. Schlossberg, MD, MBA, and is composed of all the chairs of the Health Policy-reporting committees.

“The Selection Committee was impressed with Dr. Ulchaker’s background and dedication to the AUA and our profession,” said Dr. Schlossberg. “There are tremendous professional demands on young urologists, and it is truly impressive when one carves out time to devote to organized urology. The opportunities afforded to him as the Gallagher Health Policy Scholar will certainly enrich his professional experience and benefit the AUA in the years to come.”

“The talent and experience of this year’s applicants were remarkable, which made the committee’s selection difficult. We have been very fortunate over the program’s five-year history to have such a qualified pool from which to choose. Each year the applicants bring more knowledge, diversity and understanding to the program. I hope this continues in the years to come,” said Dr. Schlossberg.

The past Gallagher Health Policy Scholars are:

David F. Penson, MD, MPH, 2007-2008
J. Quentin Clemens, MD, MSCI, 2008-2009
Christopher Saigal, MD, MPH, 2009-2010
Christopher Gonzalez, MD, MBA, 2010-2011

Click here to watch Dr. Ulchaker share his health policy experiences.

For more information about the AUA Gallagher Health Policy Scholar Program, click here.

For The Record

Breach of Privacy Lawsuit Decision Favors Healthcare Providers

Should you lose a laptop or computer disks containing unencrypted patient health information for 500 or more patients, you are required to report this incident to the U.S. Department of Health and Human Services (HHS).@blurbend HHS will then post it to their Office of Civil Rights breach disclosure Web site (link removed).

Such an unauthorized disclosure may result in significant penalties imposed on you by HHS, but will it also result in your having to pay damages to the patients who may sue you for breach of privacy? A recent court decision in Portland, OR, seems to indicate that the answer is “maybe not.” The Oregon Court of Appeals recently overturned a decision in a class action suit brought by 365,000 patients whose records were stolen from an employee’s car. Although the provider paid approximately $100,000 to the HHS Office of Civil Rights, the Court of Appeals denied the award of damages to patients because there was no evidence that the patients were victims of fraud or identity theft as a result of the inadvertent disclosure. The judges ruled that while patients may feel compelled to invest in more carefully monitoring their credit, it was not sufficient grounds for payment of damages, and claims of “emotional distress” were unfounded.

EHR Meaningful Use Stimulus Deadlines Do Not Trump Due Diligence

Industry experts agree that the meaningful use incentive has stimulated providers to purchase electronic health record (EHR) systems since the final rules were published in late 2010. In order for a urologist to collect the $18,000 first-year incentive bonus from Medicare in 2011, a provider must demonstrate meaningful use of a certified EHR beginning no later than October 1, 2011. The measurement window in Year One is defined as 90 continuous days. However, it is far more important for a potential purchaser to take the time and effort necessary to carry out essential steps before signing a purchase order, even if that means not collecting the first installment this year. Remember, a practice can implement an EHR system as late as October 1, 2012, and still qualify for the full five-year Medicare payout of $44,000 per eligible provider. Even if you do not start until 2013, you only lose $6,000 per provider. In the long run, making a poor decision about which system works best for your practice will be far more expensive than this $6,000 loss.

Be sure to take the time to carry out the following essential steps:

  • Request proposals from more than one certified system in order to ensure you are getting the best price quote;
  • During the system demonstrations, ask the representative to put the system through its paces in terms of meaningful use criteria, but even more importantly, in terms of the routine steps you personally follow in documenting patient care;
  • Identify other urology practices that have used the system you are considering and visit them to get a first-hand view of how the EHR works in daily use; and
  • Schedule sufficient training time before and after your “go-live” date to ensure that the end users enjoy the full benefits of the system.

E-mail pracman@AUAnet.org for more information.

Important Reminder about the AUA Health Policy Brief

As you know, the AUA Health Policy Brief has been transitioned into an interactive e-newsletter. This new format offers you an expanded, robust online archive of top health policy stories relating to urology, as well as single-click access to key information, including Medicare regulations, news releases and legislation. Using this new format, you will also be able to link directly to AUA Action Alerts, the UROPAC Web site, CMS reports, FDA alerts, AUA comment letters and the other online resources that we cover in the Health Policy Brief. This new, online format will make it easier than ever to stay on top of the issues that affect you and your practice, and we hope that you agree.@blurbend