Health Law & Policy

"The AACU joined 1 effort calling for the administration to remove the directive that arbiters anchor their determination to the qualifying payment amount, and instead let them consider all allowable information submitted by the parties to support their offer," says Ross E. Weber of the AACU.

A “perfect storm” of Medicare cuts threatens patient care.

"Our success depends on your assertive action and membership in organizations serving our specialty—the AACU in particular—as well as your state medical association," writes William C. Reha, MD, MBA.

“[Prior authorization is] becoming a bigger and bigger problem for each practice,” says urologist Terrence Regan, MD.

“[Prior authorization has] become part of our everyday practicing life, but it does very little to advance quality of care,” says Terrence Regan, MD.

Urology Times reached out to 3 urologists and asked them, "How did you cope with the increased stress the pandemic has placed on your life?"

"To overcome well-funded business interests and bureaucratic inertia, proponents of equitable prostate cancer screening coverage must essentially clear a high hurdle on a broken ankle," writes Ross E. Weber of the AACU.

"Don’t be me; take care of yourself, because you can’t take care of patients if you don’t," writes Henry Rosevear, MD.

A 2017 survey found approximately 75% of urologists accepted Medicaid managed care and 90% accepted Medicare Advantage, “suggesting some discernment when it comes including Medicaid managed care in a practice’s payment mix,” writes Ross E. Weber of the AACU.

"Perhaps the most substantive change to the delivery of health care during the COVID-19 pandemic has been the broad expansion of telehealth services," writes Yehuda A. Sugarman of the AACU.

"Lawmakers must prioritize medical liability protection and support health care workers on the frontlines of the COVID-19 pandemic," writes Ross E. Weber of the AACU.

"Virtual or in person, what matters is... bringing our specialty’s voice directly to the people who create and enforce the policies impacting our profession," Reha writes.

"In the coming days, months, and years, physicians must be vigilant about protecting patient privacy and safety and maintaining appropriate reimbursement standards," writes the AACU's Ross E. Weber.

"The widely varying enforceability of non-compete clauses or restrictive covenants requires physicians to pay special attention to contract provisions related to compensation as well as competition," writes the AACU's Ross E. Weber.

LUGPA President Dr. Harris discusses legislative/policy challenges in 2020.

Dr. Holton, vice chair of LUGPA's Health Policy Committee, spoke with Urology Times at the 2019 LUGPA annual meeting in Chicago.

A new report by the National Academy of Medicine urges action by government, educational institutions, and health care organizations to address the causes of physician burnout, which is experienced by up to one-half of clinicians in the U.S. and threatens patient care.

"In an ideal world, it could work pretty well. We live in a capitalistic society, however, and insurance companies are not going to voluntarily implode in order to make it easy to implement a Medicare for All system," says one urologist.

National politics, state advocacy issues, and innovative topics in urologic care came together as urologists from every practice setting and at varied points in their careers gathered in Washington for the AACU 2019 annual meeting.

"Overall, the 2020 Medicare payment proposal attempts to modernize the program and mitigate administrative burdens. The urologic community has identified room for improvement, however, including in the area of facilitating participation in advanced payment models," writes the AACU's Ross E. Weber.

"Congress must pass Stark Law reform this year, and in coordination with CMS, engage the medical community to update MACRA so that physicians have the support they need to transition to more efficient models of care delivery and better serve Medicare patients," writes Yehuda A. Sugarman of the AACU.

Willie Underwood, III, MD, MSc, MPH, the Buffalo, NY urologist elected to the American Medical Association’s Board of Trustees in June, believes physicians must step up and help influence governmental decisions designed to improve and expand health care for all Americans.

Representatives from several urology organizations discuss the concept of Medicare for All.

"State funding for GME is becoming increasingly important in the absence of significant movement from the federal government," writes the AACU's Ross E. Weber.

​"I would love to hear candidates talk about the astronomically ridiculous prices hospitals charge for surgeries, even outpatient surgeries," one urologist says.

"While the medical profession struggles most with administrative barriers to patient-centered care, cost transparency is at the root of the general population's distress," writes Ross E. Weber.

Hassles caused by Medicare Advantage prior authorization requirements are being targeted by a coalition of medical specialty organizations and a bipartisan group of congressional representatives who are responding to their concerns.

In the face of President Trump’s proposed annual budget cuts of $47.9 billion for federal graduate medical education programs over the next decade, the medical profession is urging Congress to approve legislation to significantly increase federal GME support and help combat looming shortages in both primary and specialty care.

"If elected, [Greg Murphy, MD] will become part of a de facto Congressional Urology Caucus with Neal Dunn, MD," writes the AACU's Ross E. Weber.

Few physicians will argue that prior authorization is an administrative headache. Now, however, there are mounting data showing that prior authorization does more harm than good.