September 2011
The essential resource for your practice
Volume XXI, Number 9

AUA Position Vacancy Announcement: Health Policy Vice Chair

The Board of Directors is seeking a Vice Chair of Health Policy to assist the Chair of Health Policy with execution of the health policy agenda of the AUA, as well as to ensure a smooth transition when the current Chair’s term is completed.@blurbend We are, therefore, alerting AUA membership directly to solicit applications for this position for a two-year, renewable term: June 1, 2012 – May 31, 2014. Visit (link removed) to view the full description of this position.

Individuals wishing to apply must submit a Curriculum Vitae along with a personal Statement of Interest indicating their understanding of the position, and a current Level 1 Disclosure/Conflict of Interest Policy Statement, and may not have a significant conflict as determined by the Board of Directors (view the online disclosure policy at to complete the Disclosure/Conflict of Interest Statement. 

We ask that interested candidates send these documents to the AUA at to the attention of the AUA’s President-Elect and Chair of the Vice Chair Search Committee, Dr. Dennis A. Pessis, by Friday, September 23, 2011.

Table of Contents


Coding Corner:

New ICD-9-CM Codes Become Effective October 1, 2011

Third Annual Prostate Cancer Awareness Award Reception to Honor Rep. Donna Christensen, MD

align=In recognition of Prostate Cancer Awareness Month, each September, the AUA honors a Member of Congress for his or her efforts in the fight against prostate cancer.

This year, the AUA will recognize the work of Congresswoman Donna Christensen, MD (D-VI), a former physician and current chair of the Congressional Black Caucus (CBC) Health Brain Trust. During her time in Congress, she has sponsored the Prostate Research, Imaging, and Men's Education Act (PRIME) Act, which would improve the tools used to detect and treat prostate cancer, and resolutions recognizing that the occurrence of prostate cancer in African-American men has reached epidemic proportions.@blurbend

Representative Christensen will be recognized during a special reception at the Washington Renaissance Hotel in Washington, DC, on September 22, 2011. The reception, which will follow other AUA prostate cancer awareness activities held on Capitol Hill, will run from 6 to 8 p.m. We hope you can join us.

For more information, e-mail

For The Record

Google Abandons EHR Efforts
According to a recent article in Medical News Today, Google has abandoned its efforts to launch an electronic health record (EHR) platform known as Google Health.@blurbend After a pilot project with the Cleveland Clinic, Google executives stated that the project did not “scale as hoped.” The growth in demand for EHR solutions was not as rapid as Google had anticipated, despite government interventions such as the Meaningful Use (MU) program designed to incentivize adoption of EHR products.

IPAs Assist in Small Group Adoption of EHRs
A recent study by the National Institute for Health Care Reform concluded that independent physician associations (IPAs) formed between 1980-90 to facilitate providers in small groups to accept risk-based capitation contracts can “provide a useful model to examine ways of supporting HIT [health information technology] activities in small practices.” The networking and exchange of information are natural tendencies in an IPA setting, and the adoption and implementation of electronic records are supported by the same behavior patterns. Factors mentioned in the study include access to cheaper financing through IPAs, stronger physician leadership and mentoring to bolster the morale of smaller groups during the transition, and employing technical expertise that many small groups do not have. Based on the results of the study, small urology practices who may be considering banding together for purposes of accountable care or avoidance of acquisition by a local hospital should also consider the additional benefits from collaboration in the area of EHR adoption.

PQRS Reporting via EHR Continued for 2012
Based on the proposed 2012 Medicare Physician Fee Schedule Rule released in early July 2011, the Centers for Medicare & Medicaid Services (CMS) will continue to allow participants to report on Physician Quality Reporting System (PQRS) measures directly from a PQRS-qualified EHR product. To avoid possible confusion between two separate incentive programs, CMS takes great pains in the proposed rule to differentiate between an EHR system that is “certified” for the Meaningful Use (MU) incentive program and one that is “qualified” for reporting PQRS quality measures for a practice. The proposed rule states, “The certification process for EHR technology does not test the EHR product's ability to output a file that meets the Physician Quality Reporting System measures file specifications. We are currently exploring ways to further align these two programs' reporting requirements for future years so that certified EHR technology may be used to satisfy both the Medicare EHR Incentive Program and the Physician Quality Reporting System without any additional testing.”

CMS went on to explain that when the 2012 list of qualified PQRS reporting EHR systems is released, the agency will attempt to add a notation about those systems that are also certified for MU. The CMS Web site currently contains the 2011 list of qualified PQRS reporting via EHR products.

PQRS reporting via EHR has been expanded beyond a direct data transmission from the provider’s system to CMS to allow for certain vendors to report data extracted from an EHR on behalf of a provider. These vendors will be referred to as “EHR data submission vendors.” Such vendors will have to submit a letter to CMS to become qualified and will have to sign a Health Insurance Portability and Accountability Act (HIPAA) Business Associate agreement with any provider on whose behalf they act to submit this quality data.

This expansion is evidence that CMS is trying to eventually move the entire data reporting process toward a standardized data upload from a provider’s electronic record keeping system.

For more information, please e-mail

AUA Represents Urology at Alliance of Specialty Medicine's Annual Capitol Hill Advocacy Conference

The Alliance of Specialty Medicine (the Alliance), of which the AUA is a member, held its Annual Capitol Hill Advocacy Conference from July 11-13, 2011. The Alliance, an organization composed of national medical societies, is based in Washington, DC, and represents specialty physicians in the United States. This non-partisan group is dedicated to the development of sound federal healthcare policy that fosters patient access to the highest quality specialty care.@blurbend

The AUA was represented at this event by Chiledum A. Ahaghotu, MD, FACS, chief of urology at Howard University Hospital in Washington, DC, and the R. Frank Jones Urological Society liaison to the AUA Health Policy Council; Kristen L. Chrouser, MD, MPH, a urologist with Chesapeake Urology Associates in Baltimore, MD, and a consultant to the AUA Quality Improvement & Patient Safety Committee; Mark T. Edney, MD, a urologist with Peninsula Urology Associates in Salisbury, MD, the AUA Young Urologists Committee liaison to the AUA Health Policy Council and a member of the AUA Legislative Affairs Committee; John H. Lynch, MD, FACS, chairman of the Department of Urology at Georgetown University Medical Center in Washington, DC, and the Mid-Atlantic Section Representative to the AUA Board of Directors; David F. Penson, MD, MPH, director of the Center for Surgical Quality & Outcomes Research at Vanderbilt University Medical Center in Nashville, TN, and the AUA Health Policy Council vice chair; Sanford J. Siegel, MD, FACS, president and CEO of Chesapeake Urology Associates in Owings Mills, MD; and James C. Ulchaker, MD, FACS, a urologist with the Cleveland Clinic Foundation in Cleveland, OH, and the AUA Legislative Affairs Committee chair.

AUA delegates, Drs. Penson and Ulchaker, attended the Physicians Advisory Council meeting where the Alliance’s long-term strategic plan and legislative and regulatory agenda were discussed.

Conference participants heard from many Members of Congress on key healthcare policy legislative issues currently under consideration in Congress. These speakers included:

  • Senator Ron Wyden (D-OR), member of the Finance Health Subcommittee,
  • Senator Sherrod Brown (D-OH), member of the Appropriations Committee,
  • Representative Jim Matheson (D-UT-02), member of the Energy & Commerce Health Subcommittee,
  • Representative Phil Roe, MD (R-TN-01), an obstetrician gynecologist and member of the Veterans Affairs Committee,
  • Representative Allyson Schwartz (D-PA-13), member of the Budget Committee,
  • Representative Nan Hayworth, MD (R-NY-19), an ophthalmologist and member of the Financial Services Committee,
  • Representative Larry Buschon, MD (R-IN-08), a cardiothoracic surgeon and member of the Education & Workforce Committee,
  • Representative Bill Cassidy, MD (R-LA-06), a gastroenterologist and member of the Energy & Commerce Health Subcommittee,
  • Representative Erik Paulsen (R-MN-03), member of the Ways & Means Committee,
  • In addition, Representative Dave Camp (R-MI-04), chairman of the Ways & Means Committee, joined the group after evening votes for the closing dinner to informally discuss the Alliance’s legislative priorities.

The AUA’s representatives visited more than a dozen Congressional offices to discuss the Alliance’s priorities, which included:

  1. Co-sponsorship of H.R. 452/S. 668: the “Medicare Decisions Accountability Act of 2011.” This legislation would repeal the implementation of the Independent Payment Advisory Board (IPAB), a provision in the Affordable Care Act (ACA). Starting in 2014, the IPAB’s 15‐member board of non‐elected government officials will recommend Medicare spending cuts in order to reduce the per capita rate of growth in Medicare in years when spending exceeds a targeted growth rate.
  2. Co-sponsorship of H.R. 5/S. 1099: the “Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011.” This bill is modeled after the California medical liability laws, which include reasonable limits on non‐economic damages. As outlined by the Congressional Budget Office, medical liability reform based on the HEALTH Act would decrease total healthcare spending and abate the federal deficit by $57 billion over the next decade by reducing the incentives for defensive medicine and improving the litigation system.
  3. Co-sponsorship of H.R. 1700/S. 1042: the “Medicare Patient Empowerment Act.”  With the current Medicare payment policy, the Sustainable Growth Rate (SGR), physicians will face a cut of nearly 30 percent on January 1, 2012. With this bill, patients and physicians could freely contract without penalty for Medicare services. Medicare beneficiaries would still be able to use their Medicare benefits, and physicians would be allowed to bill their patient for amounts not covered by Medicare without being forced to opt-out of Medicare for two years as current law requires.

For more information, please e-mail