December 2013
The essential resource for your practice
Volume XXI, Number 12

AUA Health Policy/ United Healthcare Leadership Discuss United’s Narrowing of their Medicare Advantage Network

On December 3, 2013, AUA Health Policy leadership communicated via conference call with United Healthcare officials regarding the narrowing of their Medicare Advantage Network. United Healthcare officials stated the fact that a physician is no longer included in the Network is not necessarily because of a specific quality or affordability issue.  Physicians are able to appeal this decision if they feel as though they have different areas of expertise or offer different services than their urology counterparts in the United Medicare Advantage Network.

Table of Contents


Coding Corner:

Preparing your Practice for 2014

AUA Names Timothy Averch, MD, FACS 2014-2015 Gallagher Health Policy Scholar

On December 10, the American Urological Association (AUA) named Timothy D. Averch, MD, FACS, the 2014-2015 Gallagher Health Policy Scholar. Dr. Averch joins the prestigious ranks of past Gallagher Health Policy Scholars.

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 AUA physicians in senior roles and participate in a week-long health policy seminar for surgeons sponsored by the American College of Surgeons and held at Brandeis University. Scholars also engage in other educational activities that ensure their immersion in and understanding of health policy issues of importance to urology.

“In a field of impressive applicants, Dr. Averch’s accomplishments, particularly his activity on behalf of urology at the national level, stood out and earned him the honor of being selected as the fifth Gallagher Health Policy Scholar,” said AUA Health Policy Chair Dr. David F. Penson, MD, MPH. “The AUA is making great strides in ensuring that we have the best and the brightest young urologists becoming conversant in the full range of regulatory, legislative, quality, reimbursement and legislative issues needed to protect and advance urology’s interests at the local, state and national levels.”

For The Record

WEDI Issues 2013 Report – “The Right Information, To the Right Place, At the Right Time”

The Workgroup for Electronic Data Interchange (WEDI) issued its 2013 report on December 5, 2013. This WEDI Report is “designed to address the electronic healthcare information exchange fragmentation problem and to identify challenges to be solved and potential innovative solutions to be implemented.” This report is a follow-up to the groundbreaking document WEDI published two decades ago in 1993. The report poses questions and challenges to be addressed in two areas of healthcare information technology. They are accelerating innovation and solving challenges.

Senate Invokes Cloture on Budget Deal; Full Vote Expected Later this Week

On Tuesday, December 17,   the Senate passed a key procedural vote in order to pass the budget deal that contains the three-month sustainable growth rate (SGR) patch.  Known as “invoking couture,” this Senate rule sets in place a time limit on debate, effectively removing the threat of filibuster and ensuring the budget deal receives a vote.  Twelve Senate Republicans joined the Senate Democrats in passing the cloture vote 67-33, signaling optimism for final passage of the budget deal later this week.  A full vote is expected on Wednesday.

This legislation, authored by House Budget Committee Chairman Paul Ryan (R-WI) and Senate Budget Committee Chair Patty Murray (D-WA), has overwhelmingly passed the House of Representatives last week.  President Obama has indicated that he will sign the bill into law.

As the Senate moves to adjourn for the year, the AUA is also monitoring its progress on the National Defense Authorization Act, which contains an amendment specific to urotrauma. Senators are expected to vote on this legislation this week as well.

Read more about the NDAA.

Read more about Congressional progress on the SGR.