Health Law & Policy

"Aetna and UnitedHealth’s decision to pass through rebates to patients is laudable, but it does not address key concerns with [pharmacy benefit manager] practices that drive up the cost of prescription drugs," writes the AACU's Brian Henderson.

"Vertical integrations are creating behemoths that limit competition within the health care space, thereby limiting options and opportunities for patients, physicians, and medical practices," according to Ally Lopshire, JD, of the AACU.

In this interview, Michael Palese, MD, discusses subspecialization, its benefits for clinicians and patients, and what the future “office urologist” may look like.

Bob Gatty recaps the recent Annual Urology Advocacy Summit in Washington.

In this "Practice Matters" column Robert A. Dowling, MD, outlines practice management and health policy sessions to watch for at the 2018 AUA annual meeting in San Francisco.

Urologists can claim substantial victories as a result of the Bipartisan Budget Act of 2018, signed into law by President Trump in February-including an end to the Independent Payment Advisory Board, which had been established by the Affordable Care Act to help control Medicare spending.

"In recent years, lawmakers in several states considered legislation to conform their laws and exceptions to those outlined in the Stark law," writes the AACU's Ross E. Weber.

James Lifton, MBA, a public (non-physician) director of the American Board of Medical Specialties, shares his observations from the recent American Board of Urology Examination Committee meeting.

If the Medicare Payment Advisory Commission has its way with Congress, urologists and other Medicare providers will be subjected to a new payment system, replacing the Merit-based Incentive Payment System that was established when the sustainable growth rate formula was ditched in 2015.

Several medical societies, including the AUA and the American Society of Clinical Oncology, are urging congressional leaders to prevent CMS from applying MIPS adjustments to Part B drug payments.

"Perhaps the biggest Medicare reform concern for urologists is the potential for provider reimbursements cuts, a threat that has continued to loom over the health care community for some time," writes the AACU's Ally Lopshire.

Switching a medication from prescription to over-the-counter status comes with challenges and risks, and is not always successful. In this interview, Roger Dmochowski, MD, discusses the pros and cons of OTC medications and explains the hurdles facing potential OTC products for urologic conditions.

Legislation that advocates believe would significantly reduce prostate cancer misdiagnoses is making its way through Congress and has the support of major urologic organizations and prostate cancer interest groups.

Giving back. Studying and following AUA guidelines. Getting a scribe in order to spend more face-to-face time with patients. These are just a few of the responses we received when we reached out to our Editorial Advisory Board, Reader Reactor Panel, and you to find out what your professional resolutions are for 2018.

"While I don’t know if I 'feel the Bern' about a single-payer system, I also don’t think I would have to start looking for a second job if we transitioned to that system," writes Henry Rosevear, MD.

Only one-fourth of urologists report understanding the choices available to them regarding the Merit-based Incentive Payment System and Advanced Alternative Payment Models created under Medicare’s Quality Payment Program, according to the Urology Times 2017 State of the Specialty survey.

New legislation to modify the Stark antitrust law to remove barriers so independent physicians can take advantage of advanced payment model opportunities provided to accountable care organizations in the Affordable Care Act has been introduced with the backing of the major organizations representing urology.

“If nearly three-fourths of currently practicing urologists become fed up with practice and leave the field, how will we meet patient demand?” asks Jeffrey Kaufman, MD.

If members of the Medicare Payment Advisory Commission have their way, the new Merit-based Incentive Payment System will be sent into oblivion, never to be heard of again.

A recently proposed bill “offers transparency measures that provide stakeholders further elucidation of how money moves through the pharmaceutical supply chain,” writes the AACU’s Brian Henderson.

“I’d like to see [the American Board of Urology] do something to make the process more applicable to our practice,” says one urologist.

SUNA President Gwendolyn Hooper, PhD, APRN, asked a few colleagues to share their urology nursing stressors.

"Patient care can continue in the office while the urologist is in the OR; APRNs and PAs can serve as a conduit for readying patients for surgery, and these providers can evaluate for potential complications post-surgery," writes SUNA's Amy Hull, MSN, WHNP-BC.

The AUA is continuing its efforts to aggressively come to the defense of PSA screening, a simple test that has been under siege by federal government regulators who have essentially flunked it as a routine procedure for assessing prostate health.

In this interview, SUNA President Gwendolyn Hooper, PhD, APRN, discusses practical tips for prevention and management of incontinence in men treated for localized prostate cancer.

Two electronic Clinical Quality Measures will help urologists report on prostate and bladder cancer care.

Quality improvement programs address all aspects of care and care delivery. Here are a few programs that impact urology, all of which were presented at the AUA annual meeting in Boston.