AUA throws its support behind USPSTF reform bill

The AUA has voiced its support for proposed legislation that would change the way the U.S. Preventive Services Task Force makes its recommendations.

The AUA has voiced its support for proposed legislation that would change the way the U.S. Preventive Services Task Force (USPSTF) makes its recommendations.

The USPSTF Transparency and Accountability Act of 2013, introduced on May 23 by Reps. Marsha Blackburn (R-TN-7), John Barrow (D-GA-12), Lee Terry (R-NE-2), and Donna Christensen (D-VI), calls for significant changes to the USPSTF and the process by which the group makes formal recommendations regarding preventive care services.

The bill also strikes the language added by the 2010 Affordable Care Act that directly ties Medicare coverage of a particular preventive service to the grade given by the USPSTF, the AUA said in a press release.

Other key changes called for by the legislation include a mandate to ensure a “balanced representation of primary and specialty care providers” and other key stakeholders in the health care community are involved in development and review of recommendations.

As part of this involvement, the USPSTF would be required to:

publish a draft research plan (including analytic frameworks, key questions, and a literature search strategy as well as methodologic guidelines for the project) to guide the systematic evidence review process

consider findings and research by federal agencies and departments

make the evidence review available for public comment

coordinate activity with other departments

consult with “external subject matter experts,” including provider and patient representatives.

In May 2012, when the USPSTF upheld its recommendation that prostate cancer screening should be avoided in all men, the AUA said it was “outraged” and “deeply disturbed” that the task force didn’t revise its recommendation to better reflect the benefits of PSA-based screening. Among its many concerns, the AUA pointed out that no urologists were involved in the development of the recommendation.

The bill establishes a Preventive Services Task Force Board comprised of providers, patient groups, and federal agency representatives. This group would provide recommendations to the USPSTF and suggest evidence for consideration, and also provide feedback on recommendations and help disseminate them when finalized.

“Recommendations about preventive care services should take into account feedback from the specialists who treat these conditions and decisions should take place in the context of a doctor-patient relationship,” said AUA President Pramod Sogani, MD. “The AUA strongly supports the inclusion of specialists on the USPSTF and other bodies that develop recommendations that impact patient care.”