Bob Gatty

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.

A new study by the Partnership for Health Analytic Research appears to bolster arguments by independent physicians and those who operate outpatient clinics that they are at a substantial financial disadvantage against hospitals when it comes retaining profits from the administration of injectable and infused drugs.

A renewed effort to establish a new Office of Men’s Health, which would improve coordination of initiatives throughout the federal government and improve education, awareness, and screening programs to improve men’s health, is now underway in Washington.

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.

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.

The 35-day government shutdown over President Trump’s border wall may have had a direct impact on many urologists beyond the many inconveniences and the cost to taxpayers that it caused-a reduction of 22% in the reimbursement rate for a popular procedure.

Members of the urology community who participated in the Annual Urology Advocacy Summit in Washington early last month urged lawmakers to support initiatives to improve patient care, including in minority populations, increase support for urologic research, and ease regulatory burdens.

With a long list of legislative priorities set for 2019, the AUA has established the AUA Political Action Committee to which members can contribute to help advance the association’s advocacy efforts in Washington.

Reversing a decision by the Department of Health and Human Services to impose a nearly 30% reduction in 340B reimbursement rates, the U.S. District Court for the District of Columbia has disappointed providers who believed that action was finally being taken to help control the cost of expensive physician-administered drugs.

As the new Congress, with the House of Representatives now controlled by Democrats, opens up shop this month, physicians-urologists included-will be looking for action on several key initiatives important to their practices and patients.

​Significant Medicare regulatory changes finalized in November will end legal incentives that have enabled hospitals to leverage Medicare payment policy to generate profits allowing them to acquire physician practices and gain competitive advantages in the health care marketplace.

“Existing Stark and associated fraud and abuse laws are one of the principal barriers to the development of [alternative payment models] and the advancement of value-based care,” says Gary M. Kirsh, MD.

America is facing a health care crisis and physicians, including urologists, and the health care organizations for which they work, are an integral component of both the cause and the solution, according to Scott MacDiarmid, MD.

Changes in the Medicare fee schedule, including plans to pay essentially the same amount for services whether performed in a hospital provider-based department (PBD) or in individual physician offices, were hailed as “significant wins” in a Health Policy Forum at the 2018 LUGPA annual meeting in Chicago.

Organizations representing urologists are urging Congress to enact protections from medical liability lawsuits for medical professionals who volunteer during emergencies, such as natural disasters or other large-scale crises.

"[The MIPS program] provides the only mechanism for many specialists and subspecialists to engage in federally-sponsored quality improvement and demonstrate their commitment to deliver high-value care," says Parag Parekh, MD, of the Alliance of Specialty Medicine.

In an amicus brief, the American Medical Association warns of interference with medical judgments.

The final recommendation on screening for prostate cancer issued May 8 by the U.S. Preventive Services Task Force, which gives a “C” grade for PSA testing in men 55-70 years of age, has been met with mixed reviews by prostate cancer-focused organizations, some of which continue to call for legislation to reform the task force itself.

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

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.

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.

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.

Nearly three-fourths of men with very low-risk prostate cancer underwent active surveillance as a primary therapy, according to a study presented at the LUGPA annual meeting in Chicago.

In his health policy briefing, Deepak A. Kapoor, MD, discusses LUGPA’s comments to CMS regarding MACRA and the 2018 Medicare physician fee schedule.

The association and its member groups are “leading the way” in developing urology-specific measures that can be used for MIPS quality reporting, says LUGPA President Neal D. Shore, MD.

It appears that Congress is finally determined to provide a permanent solution to the annual Medicare fee payment crisis, and there is a possibility that the process also could reduce pressure to end an exception to the Stark self-referral law upon which many urologists have come to rely.