Bob Gatty

The decisions by the men and women who are elected will determine whether physicians who treat Medicare are fairly reimbursed; whether the Independent Payment Advisory Board (IPAB) is allowed to continue; and even how government agencies, task forces, and advisory boards that make recommendations on specific testing and treatment protocols are allowed to function.

For urologists who strongly oppose key provisions of the Patient Protection & Affordable Care Act (ACA), upheld by the U.S. Supreme Court in late June, the best hope for change may lie in the ballot box rather than in the halls of Congress.

With all of the pressure on the federal government to curtail spending, the U.S. Department of Health and Human Services (HHS) is not kidding around when it comes to investigating and prosecuting Medicare fraud and abuse.

How would you like to have to go back for 10 years and figure out if the feds have overpaid you on a Medicare or Medicaid claim and then be required to pay up within 60 days or face monetary penalties and maybe get kicked out of federal health care programs? That's exactly what will happen unless a regulation proposed by the Centers for Medicare & Medicaid Services is significantly revised.

Finding a solution would seem to be a core issue for those interested in reforming a health care system in which Medicare is such a core component.

It has become increasingly doubtful that even if Congress passes some form of health care reform this year or in early 2010, reform of the formula on which physician Medicare payments are calculated will most likely not be included, and that is bad news.

Virtually lost in the debate over health care reform and whether it will contain a public option is an effort by advocates of medical malpractice reform to advance their cause and obtain some form of relief to the steadily increasing cost of premiums and the negative impact of defensive medicine.

The Centers for Medicare & Medicaid Services is in the process of finalizing proposed Medicare policies and payment rate changes for health care providers that would have significant impact on many urology practices.

AUA expressed 'strong opposition' to the health care reform legislation amendment eliminating the self-referral exemption for in-office ancillary services such as CT scans on the same day The Washington Post ran an article with the headline 'Doctors Reap Benefits By Doing Own Tests.'

Urologists are being urged to actively participate in health care reform because the result will have a major impact on how they conduct their practices and treat their patients for years to come.

With a new Congress powered by Democrats and a new Democratic president, sweeping actions affecting health care policy and, particularly, Medicare can be expected in 2009.

Once again, urologists are at the mercy of the politicians in Washington with a 10.1% average payment rate cut scheduled to take effect this month unless some way, somehow Congress once again comes to the rescue-and President Bush signs whatever legislation is passed.

Jerome P. Kassirer, MD, distinguished professor at Tufts University School of Medicine in Boston and visiting professor at Stanford University, Stanford, CA, has told Congress and the American people that many doctors are “on the take” from the big pharmaceutical companies, which pay them in one way or another to prescribe their drugs to patients.

CMS may grant, upon request, a repayment schedule of at least 6 months if repaying within 30 days would constitute a hardship.

Washington-The results of the November congressional elections, which caused a dramatic shift of power on Capitol Hill from Republicans to Democrats, will have significant implications for urologists and other physicians as they seek to build their practices and serve their patients in the years ahead.

Washington-Changes in federal policy that could hinder urologists' ability to provide in-office imaging services to patients appear to be on the way, threatening to toss another punch at physicians already confronting hefty Medicare fee schedule reductions in 2007.

An increase in 2007 of $190 million was requested to promote program integration and interdisciplinary team science.

Washington-On Aug. 8, 2006, the Centers for Medicare & Medicaid Services released a proposal to reform the Medicare ambulatory surgical center payment system beginning Jan. 1, 2008, and the news for urology appears to be mixed.

Specialty groups asking for time to develop effective measures

Washington--The new Medicare reform bill, which for the first time providesa prescription drug benefit for Medicare recipients, comes with a hiddencost for physicians who administer chemotherapy drugs in their offices-andperhaps their patients.

Washington-Congress has been told by its chief investigative agency thatincreasing medical liability awards, indeed, are contributing to skyrocketingpremium costs for many physicians, but that fact is not having a widespreadimpact on patients' access to health care.

Consolidating research institutions would improve collaboration and datasharing

Washington-As Congress moves toward possible approval of a new prescriptiondrug program for Medicare recipients later this summer, determination ofpayments for cancer drugs and therapeutic services may well hang in thebalance.

Washington-While leaders of both political parties say they want to provideMedicare patients with meaningful coverage for prescription drug expenses,major philosophical differences threaten to make that objective extremelydifficult to achieve.

House approves national liability insurance bill; CMS outlines changesin Medicare