Penile prosthetic funding heads into perfect storm

The 4-year-old Coalition for the Advancement of Prosthetic Urology (CAPU) is continuing to push for improved funding for penile prostheses and procedures, but the fight is likely to get steeper, according to information CAPU members were given at a meeting yesterday.

John J. Mulcahy, MD, PhD, CAPU chairman, told the attendees that the organization intended to draw as many of its members and supporters as possible to Washington, D.C., the week after Prostate Cancer Awareness Week (Sept. 17-23) to lobby senators and congressmen for improved prostheses funding.

"Too many people look at sexual function as recreational and therefore not essential," he said.

He noted that breast reconstruction was largely a cosmetic procedure at one time, but is now considered an important option for emotional recovery from breast cancer. He emphasized that the organization's efforts were to seek equality for men, not special treatment.

The twin goals of this year's lobbying campaign are to improve Medicare fees for penile prosthetics and procedures and expand private insurance coverage. Dr. Mulcahy noted that the majority of legislators were supportive of the endeavor but were hesitant to affix their names to legislation that seemed like an "unfunded mandate."

Four major economic issues are coalescing to affect Medicare fees, according to Robin Hudson, regulatory affairs manager at AUA. These are a 5-year review of physicians due this year; the implementation of the deficit reduction act of 2005; a projected cut in the conversion factor that affects physician fees; and changes in the way practice expense methodologies are determined. The overall impact of these should be an increase in the reimbursements for many procedures, but not necessarily those for penile prosthetics.

Dr. Mulcahy is optimistic that continued efforts by CAPU would eventually lead to improved funding, although those funding improvements will probably come in increments spread over years. He added a certain urgency to his message, noting that the urology workforce was projected to decline in the next 10 years at the same time the infamous baby boomers are scheduled to undergo a record number of prostatectomies for prostate cancer.