February 2013
The essential resource for your practice
Volume XXI, Number 2

AUA Discusses SGR Proposal with House Ways and Means Committee Staff

On January 31, AUA Associate Executive Director of Public Policy and Practice Support, Kathleen Wilson, PhD, CAE, and Director of Government Relations and Advocacy, Sandie Preiss, MPA met with Majority Staff Member Brett Baker, of the House Ways and Means Committee, to discuss and review the committee’s proposal to permanently repeal and replace the sustainable growth rate (SGR), the formula used to determine the Medicare physician fee schedule.

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Coding Corner:

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CMS Releases Sunshine Act Final Rule

Starting on August 1, 2013 drug, device, biological and medical supply manufacturers covered under federal programs (i.e., Medicare, Medicaid or the Children’s Health Insurance Program) must begin to collect and report to the government payments or transfers of value they make to physicians and teaching hospitals. The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), will then make the information available online for review by the public. The data will be posted online by September 30, 2014. This reporting is required under the National Physician Payment Transparency Program: Open Payments, also known as the Sunshine Act, one of the items included in the Affordable Care Act (ACA) designed to “create greater transparency in the health care market.” 

2011 CMS Utilization Data Shows No Significant Changes for Top Urology Codes

The Centers for Medicare & Medicaid Services (CMS) has released the 2011 utilization data that was used for the final rule “Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule, DME Face-to-Face Encounters, Elimination of the Requirement for Termination of Non-Random Prepayment Complex Medical Review and Other Revisions to Part B for CY 2013”.

AUA Joins IPAB Coalition in Endorsing New IPAB Repeal Legislation

On January 23, the American Urological Association (AUA) joined 25 other medical organizations in announcing support of the Protecting Seniors’ Access to Medicare Act, introduced by Reps. Phil Roe, MD (R-TN) and Allyson Schwartz (D-PA). The bipartisan bill would repeal the Independent Payment Advisory Board (IPAB). 

Established by the Affordable Care Act, the IPAB is an unelected and unaccountable body of 15 persons tasked with developing ways to reduce Medicare spending. The IPAB is slated to begin work as early as April 30, 2013. As presently structured, the IPAB cannot include any practicing physicians, presenting a worrisome absence of insight into the needs of patients and physicians alike.