Health Law & Policy

John Lam, MD, outlines the legislative efforts underway, the impact of prior authorization on patient care, and the role organized medicine can play in pushing for meaningful change.

Jennifer Miles-Thomas, MD, URPS, MBA, discusses the AUA's legislative priorities along with issues in medicine related to artificial intelligence.

"Developing a relationship with your legislator is just as important at the state level as it is at the federal level," says Hans Arora, MD, PhD.

"The AACU has been discussing the evolution of state policy to ensure that biomarker testing, including PSA screening, is covered by payers," writes Ron Lanton, Esq.

This bill would cut funds for research projects in disease states such as prostate cancer, bladder cancer, kidney cancer, and interstitial cystitis.

“Five years after telehealth suddenly became a routine part of care for most Americans, we show that it has not led to runaway utilization or spending. This kind of in-depth analysis can inform its future," says Chad Ellimoottil, MD, MS.

The 15 drugs identified in this round of negotiations add to the 10 selected in the first round of negotiations that took place in 2023 and 2024.

The bill, H.R. 2474, would tie the Medicare physician fee schedule to the Medicare Economic Index (MEI), something the AACU and the AMA have long supported

"We wanted to make sure that it was highlighted that men really need to be screened, and it should be covered by insurance," says Adam Murphy, MD, MBA, MSCI.

"The future's bright, and I think we have a lot more people engaged," says Denise Asafu- Adjei, MD, MPH.

"Helping urologists establish practices in rural areas and incentivizing those practices is so important," says Kevin Koo, MD, MPH.

"This year's Summit was one of the biggest and most exciting so far," says Kevin Koo, MD, MPH.

Telemedicine risks can be managed by staying informed and educated.

Based on 5- and 10-year study periods, physicians with single or multiple paid medical malpractice claims “were shown to have a greatly elevated risk of having additional paid claims during a future period,” the authors wrote.

While AI is promising, there are potential legal and ethical challenges that must be addressed, according to the experts.

"The AACU joined 1 effort calling for the administration to remove the directive that arbiters anchor their determination to the qualifying payment amount, and instead let them consider all allowable information submitted by the parties to support their offer," says Ross E. Weber of the AACU.

“My opinion is that the practices that continue to utilize telemedicine moving forward after the pandemic are going to be the leaders in urology,” says Lisa J. Finkelstein, DO.

Among the highlights will be a talk from Senator Bill Cassidy, MD (R-LA).

A “perfect storm” of Medicare cuts threatens patient care.

"A lot of ancillary providers want more privileges that the physician has, and we have to be the guardians and the reason we're doing this is to protect our patients so that they get the best care available to them," says William C. Reha, MD, MBA.

"Our success depends on your assertive action and membership in organizations serving our specialty—the AACU in particular—as well as your state medical association," writes William C. Reha, MD, MBA.

Terrence Regan, MD, also discusses appropriate use criteria for advanced imaging from the Centers for Medicare & Medicaid Services.

“[Prior authorization is] becoming a bigger and bigger problem for each practice,” says urologist Terrence Regan, MD.

“[Prior authorization has] become part of our everyday practicing life, but it does very little to advance quality of care,” says Terrence Regan, MD.

Urology Times reached out to 3 urologists and asked them, "How did you cope with the increased stress the pandemic has placed on your life?"