Urologists support USPSTF 'accountability' act; bill follows victory at AMA meeting

Three leading urology associations have announced support for the USPSTF Transparency and Accountability Act of 2012 (H.R. 5998), which calls for significant changes to the U.S. Preventive Services Task Force (USPSTF) and the process by which the group makes formal recommendations regarding preventive care services.

The bipartisan legislation was introduced just days after the American Medical Association House of Delegates passed a resolution put forth by the urology community that expresses concern over the USPSTF’s recent recommendations on prostate and breast cancer screening and encourages the USPSTF to implement procedures that allow for "meaningful input" from specialists on a given preventive care topic.

H.R. 5998 was introduced by Reps. Marsha Blackburn (R-TN) and John Barrow (D-GA), along with Reps. Donna Christensen (D-VI) and Lee Terry (R-NE). In a joint press release issued by the AUA, the American Association of Clinical Urologists, and the Large Urology Group Practice Association, the three groups said the bill strikes language added by the 2010 Patient Protection and Affordable Care Act that directly ties Medicare coverage of a particular preventive service to the grade given by the USPSTF, which is currently comprised primarily of general practitioners without input from specialists on specific diseases.

Other key changes called for by the legislation include a mandate to ensure a "balanced representation of primary and specialty care providers" and other key stakeholders in the health care community are involved in development and review of recommendations.H.R. 5998 further establishes a Preventive Services Task Force Board comprised of providers, patient groups, and federal agency representatives. This group would provide recommendations to the USPSTF and suggest evidence for consideration when a particular service is proposed for review, and also provide feedback on draft and final recommendations and help disseminate them when finalized.

"Allowing independent bodies to make broad, population-based decisions regarding which tests or diagnostics are appropriate without consultation from the specialists who treat these diseases is inappropriate," said Rep. Blackburn. "I’m pleased to have worked with the AUA to introduce this legislation to ensure that preventive care recommendations are not made in a vacuum. Patients and their physicians have the right to choose which tests are best for them."

For the full release from the AUA, AACU, and LUGPA, click here.

The legislation was introduced soon after the AMA House of Delegates passed a resolution that creates new AMA policy regarding the USPSTF.

The two-part resolution states that the "AMA expresses concern regarding recent recommendations by the USPSTF on screening mammography and PSA screening and the effects these USPSTF recommendations have on limiting access to preventive care for Americans." In addition, the resolution encourages the USPSTF to "implement procedures that allow for meaningful input on recommendation development from specialists and stakeholders in the topic area under study."

The urology delegation that put forth the resolution and lobbied for its passage included William Gee, MD, Aaron Spitz, MD, Willie Underwood, MD, MPH, and Roger Satterthwaite, MD, MPH. Jeffrey Kaufman, MD, a delegate who was unable to attend the meeting, helped to craft the resolution.

"This demonstrates how the AMA can be important and work for specialty physicians," Dr. Gee told Urology Times. "I hope that AUA members recognize this and realize that the federal government, state governments, hospitals, insurance companies, Medicare, and others all closely look at AMA policies."

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