What You Should Know
The U.S. Preventive Services Task Force (USPSTF) is a government task force comprised of members from the fields of primary care and preventive medicine, which currently makes evidence-based recommendations about clinical preventive services without consulting patients or specialists in the management of related conditions. Through the USPSTF Transparency and Accountability Act, the AUA is actively working with lawmakers to reform this government body, creating transparency and accountability within the task force while also incorporating input and feedback from patients and specialists involved in treating the conditions for which recommendations are being developed. Since 2012, the AUA has advocated in support of the USPSTF Transparency and Accountability Act. Rep. Marsha Blackburn (R-TN-07) first introduced the bill during the 112th Congress and has reintroduced it during each subsequent Congressional session. Now in the 115th Congress, the most recent version of the bill, H.R. 539, was introduced in January 2017 by Rep. Blackburn and Rep. Bobby Rush (D-IL-1).
H.R. 539 would require the USPSTF to:
- Publish research plans and make available reports on such evidence and recommendations for public comment;
- Ensure medical specialty physicians are consulted;
- Establish a stakeholder board to ensure input on developing, updating, publishing and disseminating evidence-based recommendations;
- Codify the current grading system so it can't be changed without review; and
- Ensure that Medicare or other payors cannot deny payment for a preventive service solely based on the Task Force grade.
USPSTF recommendations on clinical preventive health services have created confusion among patients and the primary care community for years. For example, in May 2012 the USPSTF recommended against the prostate-specific-antigen (PSA) based screening test for prostate cancer in all men, regardless of risk. This decision counters the informed opinion of expert physicians, as well as decades of data and research showing early detection of prostate cancer, when in its most manageable state saves lives The insulated USPSTF process disallows meaningful contributions from medical specialists and the public who, in this case, would have provided evidence on the benefit of PSA-based screening in vulnerable populations including African Americans and men with a family history of the disease.
Section 2713 of the Patient Protection and Affordable Care Act (ACA) grants USPSTF recommendations the force of law, making them de facto mandates on which services private plans and public programs, such as Medicare, must reimburse. Having been empowered in this way, it is essential that this advisory panel be subject to greater transparency and accountability.
What You Can Do
Visit the AUA Advocacy Center for updates on alerts and calls to action on this issue.
115th Congress (2017-2018)
- AUA Comments to USPSTF Draft Recommendations on Screening for Prostate Cancer [pdf]
May 8, 2017
- Prostate Cancer Community Responds to New Recommendation for Prostate Cancer Testing
April 17, 2017
- AUA Responds to USPSTF Draft Recommendations on Screening for Prostate Cancer
April 11, 2017
- Stakeholders Applaud USPSTF for Including Urologist in Review Process for Updated Prostate Cancer Recommendations
February 14, 2017
- AUA Announces Support for USPSTF Transparency and Accountability Act of 2017
January 13, 2017
To read comment letters addressed to past Congresses, click on the link in the sidebar.