United States Preventive Services Task Force (USPSTF) [pdf]

Request

U.S. urologists urge Congress to require that the U.S. Preventive Services Task Force (USPSTF) have greater accountability and transparency. We urge representatives to cosponsor H.R. 1151, the "USPSTF Transparency and Accountability Act of 2015" introduced by Representatives Marsha Blackburn (R-TN) and Bobby Rush (D-IL). In addition, we ask senators to support the reintroduction of the "Healthy Families Act of 2014" by Senator Deb Fischer (R-NE).

Background

The "USPSTF Transparency and Accountability Act" would include critical reforms that would require the USPSTF to: (1) publish research plans to guide its systematic review of evidence and new science relating to the effectiveness of preventive services; (2) make available reports on such evidence and recommendations for public comment; (3) codify the grading system so it cannot be changed without appropriate review; and (4) establish a stakeholders board to advise it on developing, updating, publishing, and disseminating evidence-based recommendations. In addition, the bill would ensure that Medicare or other payors cannot deny payment for a preventive service solely based on the Task Force grade.

The "Healthy Families Act of 2014" would require that the USPSTF is compliant with the Federal Advisory Committee Act (FACA), including holding meetings open to the public.

Rationale

Currently, the USPSTF has little accountability. The Task Force members are appointed by an unelected official, and it does not meet with relevant stakeholders during their review process nor do medical specialists serve on the Task Force. Although recommendations are intended for a primary care audience, they impact patient access to appropriate specialty care.

Although the USPSTF has issued several controversial recommendations, urology is specifically concerned about its 2012 recommendation against prostate-specific antigen (PSA) based screening for prostate cancer for all men, regardless of risk.

In 2013, the AUA released a clinical practice Guideline on the Early Detection of Prostate Cancer developed using evidence from a systematic literature review. This guideline supports the use of the PSA test in a more-targeted manner, whereas the USPSTF recommendation does not encourage its use in men of any age. We support a man's right to be tested for prostate cancer – and to have his insurance pay for it, if medically necessary – if, in fact, he decides to do so following a detailed conversation with his physician about the benefits and harms of screening.

Contacts

To cosponsor H.R. 1151 the "USPSTF Transparency and Accountability Act of 2015," please contact Karen Summar (Rep. Blackburn) at 5-2811 or karen.summar@mail.house.gov or Orlando Jones (Rep. Rush) at 5-4372 or orlando.jones@mail.house.gov. To support the reintroduction of the "Healthy Families Act of 2014," please contact Liz Ruth (Sen. Fischer) at 4-6551 or liz_ruth@fischer.senate.gov.