Health Law & Policy

The debate over questions of self referral and inappropriate utilization of medical imaging services by physicians is continuing in Washington, with possibly restrictive recommendations looming from the Medicare Payment Advisory Commission and provisions of the health reform law being implemented.

A large number of organizations in the medical community-including the AUA-have launched a campaign to persuade Congress to repeal the Independent Payment Advisory Board (IPAB), an entity designed by Congress to take politics out of decisions involving changes to federal health programs such as Medicare.

U.S. Sen. John Cornyn (R-TX) has introduced a bill that would repeal the Independent Payment Advisory Board (IPAB), a body created by the health care reform law whose charge is to reduce the per capita rate of growth in Medicare spending.

Implementation of the "Red Flags Rule" by the Federal Trade Commission, which would require medical practices and other businesses to take specific steps to minimize identity theft and which has been challenged by the AUA, has been delayed until a federal appeals court rules on a lawsuit by the American Bar Association.

Make sure that the requesting partner has clear documentation of the request for determination of whether the consulting physician should take over care of the patient, and make sure the consulting physician documentation is clear on the request for determination of care.

Possible new federal self-referral restrictions on radiation therapy services are being aggressively challenged by a nationwide group of integrated group practice physicians who take issue with charges that physician ownership of equipment used in the procedures results in increased and unnecessary services and Medicare costs.

How do you plan cash flow with more delays and/or significant reductions looming for Medicare?

If we don't [lower costs and eliminate waste] soon, our patients, our practices, our families, the economy, and our nation will suffer.

The Patient Protection and Affordable Care Act of 2010 specifically states that anyone receiving Medicare payments is obligated to identify and refund overpayments within 60 days of recognition.

The American Medical Association, American Osteopathic Association, and the Medical Society of the District of Columbia have filed a suit in federal court seeking to prevent the Federal Trade Commission from extending identity theft regulations to physicians.

Health care reform is what it is, and we have to learn to live with it for now and the foreseeable future. Currently, it is the law of the land.

Urology Times found urologists who place themselves in each of the camps on health care reform, but perhaps the largest group wishes someone could explain what the legislation actually means for them.

Along with their ability to standardize and improve record keeping and communication, EHRs also have medicolegal implications, both benefits and possible drawbacks.

Just like any run for office, urologists need to work to elect judicial candidates whose philosophy on medical malpractice caps reflects their own.

As part of reform, It is clear that the government is starting to tighten control of physician-owned ancillary services.

What is it going to take for Congress to stop playing games with physicians who treat Medicare patients and develop an effective solution to the fee cuts that are scheduled every year and require last-minute, short-term solutions?

A major cause of concern among urologists and other physicians with large Medicare patient practices is a provision in the new law that will establish a new Independent Payment Advisory Board that is charged with reducing the per capita rate of growth in Medicare spending indefinitely.

The American Association of Clinical Urologists has always been the political voice for organized urology and believes that urologists themselves must speak to elected officials directly.

Practices with 20 or fewer physicians may be exempt from the "Red Flags" rule, which requires physicians' practices and other businesses to spot and report identity theft, according to a bill unanimously passed in October by the U.S. House of Representatives.

As this issue of Urology Times went to press, passage of major health care reform legislation-on which AUA and other health care groups had devoted considerable time, energy, and resources-was in jeopardy.

Once again, urologists have had to face the prospects of huge reductions in their Medicare reimbursement rates because of the inability of Congress to resolve the problems imposed by the sustainable growth rate (SGR) formula, and once again, they must count on a temporary reprieve.

With guidance from the American Association of Clinical Urologists, Inc., urologists have scored key grassroots victories in state legislatures across the country over the past year.

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.

How will urologists be affected by reform measures aimed at bolstering the role of primary care physicians?

Once again we face a Medicare payment update for the new year that raises a number of questions, the answers to which are not favorable to practicing urologists.

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.

As the debate over health care reform rages, one thing is certain: Regardless of what happens in Washington, changes will occur in 2010 that will directly affect your practice.

Urologists from around the country give their opinions on health care reform.

Urologists plan on complying with new rules, but some see it as 'overkill.'

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.'