Health Law & Policy

Two issues of concern to urologists?compensation for ancillary services and the sustainable growth rate (SGR) formula?are among the issues discussed by the Medicare Payment Advisory Commission (MedPAC) in its June 2011 report to Congress.

The AUA recently voiced its support for the Prostate Research, Outreach, Screening, Testing, Access and Treatment Effectiveness (PROSTATE) Act of 2011, H.R. 2159, which was introduced in the U.S. House of Representatives by Rep. Edolphus Towns (D-NY) and Paul Broun, MD (R-GA).

In March 2011, urologists united their voices once again in Washington at the 6th Annual Joint Advocacy Conference (JAC).

The American College of Surgeons has called on members of Congress to eliminate the current sustainable growth rate (SGR) Medicare physician payment formula and transition over the next 5 years to a new physician payment system that fairly reflects the costs of providing high-quality health care.

The non-medical use of prescription drugs is thought to represent the fastest growing drug problem in the United States, and urologists aren't immune to it.

The Patient Protection and Affordable Care Act, the new health care reform law, takes some "paltry steps" toward improving the quality of medical care, but it ignores the most fundamental problem that still begs for a solution-how to fairly compensate physicians who treat Medicare patients.

If the trends currently in motion continue, you will see the beginning of accountable care organizations in 2012, with increasing numbers of them year by year, unless there is a repeal of the shared savings portion of the Affordable Care Act or the final rule restricts the potential savings that can be obtained by any ACO.

The AUA has announced its support for newly introduced legislation designed to address urotrauma, a growing concern among active military personnel and veterans.

As physicians, hospitals, insurance companies, and other organizations grapple with this new entity, it appears there are more questions than answers.

Determined to defend their profession and their practices, some 180 urologists from 39 states across the nation came to Washington in late March for the 2011 Joint Advocacy Conference, sponsored by the AUA and the American Association of Clinical Urologists.

With Republicans in control of the House of Representatives, there is some potential good news and bad news for physicians, including urologists, as the drive to slash the federal deficit moves into high gear.

Cries of "copycat" may be heard from a chorus of voices as legislators "borrow" policy initiatives from their fellow mad scientists in the "laboratories of democracy."

The AUA, the American Association of Clinical Urologists, and seven other specialty societies have joined forces to support legislation introduced in the Maryland General Assembly to amend the state?s current self-referral law, which the AUA says threatens to seriously restrict patient access to imaging and radiation therapy services.

Urologists respond to the FDA's ruling on dutasteride and finasteride.

With huge Medicare reimbursement cuts for physicians now off the table for this year, the Medicare Payment Advisory Commission (MedPAC) has proposed a 1% increase for 2012 as a way of encouraging physicians to continue to treat Medicare patients.

Given mounting pressures on Medicaid programs and new health insurance products, physicians must retain the flexibility to make their own business decisions and not be required to accept payments for their services that do not meet their costs.

Arguments abound as to whether the Patient Protection and Affordable Care Act will drive health care costs up or down. Until provisions related to health insurance, information technology, Medicare, and Medicaid are implemented over the next several years, those battles will mostly be fought in arenas that do not impact the practice of urology today.

Will 2011 be the year that medical malpractice reform becomes a reality? The new political alignment in Congress appears to offer more hope than in many years past, and advocates are anxious to achieve that long-elusive objective.

For several urologists, the concept behind reform was strong, but the logistics of implementing it are daunting.

Urologists have strong opinions about politics and health care reform. About four out of five urologists are extremely or very concerned about declining reimbursement, increasing government regulations, and health care reform regulations.

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.