From the Chair
I am pleased to share updates from the AUA Public Policy Council that may benefit your Section members. Our updates include information on AUAPAC successes, the Annual Urology Advocacy Summit, and our efforts to finalize the 2020 Defense Appropriations Act. Our thanks to the New England Section’s Board of Directors for agreeing to support AUAPAC’s administrative operations and to Drs. Toby Chai, Daniel Frendl, and Arthur Tarantino for their generous individual donations during the fall Health Policy Weekend meetings that were held at AUA headquarters in Linthicum, MD.
Gallagher Health Policy Scholar: Robert Bass, MD Named 2020 Scholar
Last week, the AUA announced that Dr. Robert Bass had been selected as the 2020 Gallagher Health Policy Scholar. Dr. Bass is the newest participant in this important, year-long program that provides intensive training on a wide range of health policy issues. He joins a long line of program participants who have gone on to be established advocacy leaders for urology, including our current Public Policy Council Chair Dr. Chris Gonzalez and Chair-Elect Dr. Eugene Rhee. Congratulations, Dr. Bass!
Read the full press release.
AUAPAC Update: AUAPAC Has Successful Inaugural Year
Due to the support of many AUA members, AUAPAC’s first year of existence was a banner one! The AUA was able to support 17 House and Senatorial candidates who champion issues important to the practice of urology. Eight of whom were practicing physicians before coming to Congress, including urologists and AUA members Reps. Neal Dunn and Greg Murphy.
Other supported lawmakers include members of the Appropriations Committee, the House Energy & Commerce and Ways & Means Committees, and the Senate Finance and Health, Education, Labor & Pensions Committees. The full list of AUAPAC-supported candidates in 2019 is as follows:
- Sen. Marsha Blackburn (R-TN)
- Sen. Mike Braun (R-IN)
- Rep. Michael C. Burgess, MD (R-TX-26)
- Sen. Bill Cassidy, MD (R-LA)
- Rep. Neal Dunn, MD (R-FL-02)
- Rep. Andy Harris, MD (R-MD-01)
- Rep. John Joyce, MD (R-PA-13)
- Rep. Robin Kelly (D-IL-02)
- Rep. David McKinley (R-WV-01)
- Rep. Greg Murphy, MD (R-NC-03)
- Rep. Phil Roe, MD (R-TN-01)
- Rep. Dutch Ruppersberger (D-MD-02)
- Rep. Markwayne Mullin (R-OK-02)
- Rep. Frank Pallone (D-NJ-06)
- Rep. Raul Ruiz, MD (D-CA-36)
- Rep. Bobby Rush (D-IL-01)
- Rep. Terri Sewell (D-AL-07)
If you would like more information on AUAPAC and its ongoing activities, please visit www.MyAUAPAC.org
2020 Annual Urology Advocacy Summit: Registration Launched; Draft Agenda Online
Registration is now open for the 2020 Annual Urology Advocacy Summit. There are nearly 100 registrants so far. Last year, more than 240 members of the urology community came to Washington, DC and we are anticipating the same number of attendees this year, so secure your spot today! Also, we are proud to say the New England section has once again agreed to participate in the resident/fellow/young urologist “match” program, which provides stipend opportunities for our younger members to attend the summit – thus encouraging them to get engaged in health policy and advocacy earlier in their careers.
Now in its third year, the 2020 AUA Summit will feature several high profiles, keynote speakers, including Margaret Brennan – Moderator of “Face the Nation” and Senior Foreign Affairs Correspondent for CBS News – as well as a full day of meetings on Capitol Hill and/or at federal agencies in the area. A draft Summit agenda has been posted online. The NEAUA will be participating in a larger panel discussion on the value of state advocacy, which is a particularly timely issue seeing in Massachusetts, for example, there are efforts underway to change the process and forms for surgical consents.
We look forward to welcoming all of NEAUA’s participants to the Summit to complement our work at the federal and state level!
Research Advocacy: AUA Supports Efforts to Finalize 2020 Defense Appropriations Act
On December 3, the AUA joined members of the Defense Health Research Consortium in a letter urging House and Senate leadership to complete final negotiations on the fiscal year 2020 Defense Appropriations Act and move the bill expeditiously through the House and Senate toward enactment. The letter highlights that a further delay in completing the fiscal year 2020 defense budget, or subjecting the defense budget to a long-term continuing resolution, will inflict irreversible damage on the Defense Health Research Programs, including the Congressionally Directed Medical Research Programs, at the Department of Defense (DoD).
Failure to enact a final bill will have major negative health implications for the millions of Americans, especially veterans, suffering from chronic and debilitating disorders including bladder, kidney, and prostate cancers.
Local and Regional Updates
The following are updates in your Section. Please contact AUA Executive Vice President Kathleen Z. Shanley at kshanley@AUAnet.org for more information on any of these issues.
A majority of state legislatures have adjourned for the remainder of 2019. Regardless, the AUA will continue to monitor state legislative, regulatory, and insurance issues that affect urology.
The following insurance update covers Connecticut, Maine, Massachusetts, New Hampshire and Rhode Island.
Effective for dates of service beginning December 1, 2019, Harvard Pilgrim will require that all commercial professional claims and facility claims, with the exception of inpatient facility claims, include a valid National Drug Code (NDC) number in addition to the appropriate revenue, HCPCS, or CPT code. A valid NDC will continue to be required when billing for any non-specified drug code.
Read the complete update.
Harvard Pilgrim has updated the commercial medical policy for Cryotherapy for Prostate Cancer. The policy has been updated to specify that the procedure is considered medically necessary when documentation confirms that the member has not undergone previous local therapy for prostate cancer (for example, radical prostatectomy or radiation) and has localized prostate cancer, stages T1-T3. As a reminder, prior authorization is required for all cryotherapy procedures requested for members of Harvard Pilgrim’s commercial plans.
Read the complete update.
Boston Medical Center has revised the Posterior Tibial nerve Stimulation medical policy with the following changes to criteria: Added the following contraindication: member with neurogenic overactive bladder syndrome/neurogenic lower urinary tract dysfunction.
Read the complete policy.
SB 584—Balance Billing
Senator Paul Feeney (D) introduced SB 584, which prohibits increases in dollar amounts for copayments, deductibles, tiered provider network copayments, and other cost-sharing plan design features except in certain circumstances.
On November 14, SB 584 was heard before the Joint Committee on Financial Services. No vote was taken and timeline for further consideration has not yet been set. The bill is available here: 1/22/2019 Version
ICYMI: Updates from the AUA Policy & Advocacy Brief blog
Congressional Outreach: AUA Meets with Legislator on Priority Issues; Attends Meet & Greet with Men’s Health Caucus Co-Chair
On December 5, the AUA met with the office of Rep. Jimmy Panetta (D-CA-20) to discuss H.R. 3534, the USPSTF Transparency and Accountability Act, as well as veterans’ issues. Rep. Panetta introduced legislation to direct research into the correlation between radiation exposure and prostate cancer in veterans. The study would help determine if prostate cancer should be included as a presumptive disability for certain compensation offered to veterans who may have been exposed to ionizing radiation or radiation during their military service. The AUA Veterans Health Workgroup reviewed the bill and unanimously agreed that the AUA should endorse the measure. As a result, the AUA plans to issue a formal support letter and hopes to work closely with his office further on veteran and prostate cancer issues moving forward.
In addition, on December 4, the AUA attended a meet and greet with Rep. Markwayne Mullin (R-OK-02) hosted by the Alliance of Specialty Medicine. Rep. Mullin serves on the House Energy & Commerce Committee and co-chairs the Congressional Men’s Health Caucus. Rep. Mullin discussed his concerns with the current surprise billing legislation and accepted the Alliance’s point on having an independent dispute resolution process that is fair to both providers and payors.
As a reminder, throughout the year, the AUA has had numerous conversations with Rep. Mullin on top health policy issues both in congressional and political settings. He remains a champion of the many issues that impact a urologist’s ability to provide quality care to patients around the country.
Urologic Workforce: AUA Sends Comment Letter to House Ways & Means Committee
On November 29, the AUA submitted a comment letter in response to the House Ways & Means Committee’s request for information soliciting input on priority topics that affect health status and outcomes in underserved communities. The information collected will be used to inform the bipartisan Rural and Underserved Communities Health Task Force as it works to draft legislation to identify the causes of health care disparities, develop strategies to close gaps in care, and ultimately improve health care outcomes in both urban and rural underserved areas.
The AUA’s comments focused mainly on the specialty workforce shortage and how it plays a significant role in health care disparities in rural parts of the country. “It is also important for the Task Force to consider that rural areas account for 50 million Americans; however, according to the AUA Census, which is a systematically designed, specialty-representative survey of urology, reports that 62 percent of counties in the United States have no urologist and, as a result, the mortality rate for kidney, prostate, and bladder cancer are all higher in these counties," the letter states.
Top Takeaways: First Friday Clinician Outreach Meeting, December 6, 2019
The top takeaway from the Centers for Medicare & Medicaid Services (CMS) December Clinician Outreach Meeting focused on lessons learned from the Transforming Clinical Practices Initiative (TCPI), a practice transformation and quality improvement initiative of the Center for Medicare & Medicaid Innovation (CMMI). Read more.
Medicare Physician Fee Schedule: Alliance of Specialty Medicine, AUA Voice Concerns
The AUA has joined 11 other organizations, as part of the Alliance of Specialty Medicine, to voice our concerns regarding the provisions of the Centers for Medicare & Medicaid Services’ (CMS) Final Rule for the Medicare Physician Fee Schedule. Comments include the following:
Payment for Evaluation and Management (E/M) visits: Recommend, that regardless of the number and level of E/M services that are delivered, when post-operative E/M services are furnished, they should be valued based on the updated E/M values. We also urge CMS to reverse its decision to exclude the updated E/M values in codes with global periods.
Principal Care Management (PCM) Services: CMS finalized separate coding and payment for these services, and requires management by another, more specialized, practitioner. We urge CMS to work with the Alliance to establish educational materials that clearly describe the differences in and appropriate scenarios for coding and billing PCM services.