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This week’s update includes information on our Surgical Coalition advocacy on the global codes, Hill meetings on IPAB repeal, and our partnership with ZERO on localized events in states that do not have legislation in place that mandates coverage of prostate cancer screening. Global Surgery : Surgical Coalition, AUA Ask Secretary Price to Delay Data Collection On April 21, the AUA participated in a sign-on letter with our partners in the American College of Surgeons’ Surgical Coalition. The letter was sent to HHS Secretary Tom Price, MD, dealing with the process to collect data on resources used in furnishing global services. The attached letter, signed ...
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After two long years of discussion, the Medicare Payment Advisory Commission (MedPAC) voted unanimously on April 6 on a set of recommendations for Congress to decrease spending for Medicare Part B drugs and biologics. Under the recommendation package, Medicare Part B drug payment policy would be changed in 2018 to: (1) require all manufacturers of products paid under Part B to submit ASP data, and impose penalties for failure to report; (2) reduce wholesale acquisition cost (WAC)-based payment to WAC plus 3 percent; (3) require manufacturers to pay Medicare a rebate when the ASP for their product exceeds an inflation benchmark, and tie beneficiary ...
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The future of Medicaid remains in flux following the defeat of the Republican healthcare bill last month. Initially expanded under the Affordable Care Act, Medicaid covers citizens with incomes at or below 133 percent of the federal poverty line in the 31 states that have accepted the expansion. The bill put forth by Congressional Republicans, the American Healthcare Act, would have repealed the ACA Medicaid expansion and significantly tightened the program’s eligibility. Some Republican-led states have reconsidered their opposition to the expansion following this defeat. In Kansas, the Republican state legislature passed a bipartisan bill to expand ...
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This week’s update includes information on the AUA’s meeting with Health and Human Services Secretary Tom Price, MD, our joint statement on the U.S. Preventive Services Task Force recommendations on prostate cancer screening, and our testimony in support of the American College of Surgeons (ACS)/Brandeis University on Advanced Alternative Payment Models. Regulatory Relief: AUA Meets with HHS Secretary Price’s Office As a member of the Regulatory Relief Coalition, the AUA -- along with several other medical societies -- met with staff in the office of the Health and Human Services (HHS) Secretary Tom Price, MD, on April 13 to request use of regulatory authority ...
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One part of the new Merit-based Incentive Payment System (MIPS) track of the Quality Payment Program (QPP) is Quality reporting. Much like its predecessor program, the Physician Quality Reporting System or PQRS, there are many options for submitting your Quality data to the Centers for Medicare & Medicaid Services (CMS). First, a provider must determine if he/she will report individually or join with others to report as a group. After that, the individual or group must decide which reporting mechanism to use. Options for individuals include claims, registry, Qualified Clinical Data Registry (QCDR), and electronic health records (EHR). All of these options, plus ...
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The Food and Drug Administration (FDA) is advising consumers not to purchase or use a group of supplements promoted for sexual enhancement because an FDA laboratory analysis confirmed they contain hidden ingredients.  Black 3K Plus Male Sexual Enhancement Capsules Power Male Sexual Stimulant Rhino 7K 9000 Male Performance Booster Rhino 8 Platinum 8000 All of these supplements contain sildenafil, an active ingredient used in FDA-approved prescription drugs used to treat erectile dysfunction. While there are no reports of illness associated with the list of supplements, they could pose a threat to consumers because the undeclared product ...
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On May 11, as part of the 2017 AUA Practice Management Conference in Boston, Edna Maldonado, certified professional coder and AHIMA ICD-10-Trainer, will deliver her presentation “Strategies for Denials- Maximizing your Revenue Stream” to our conference attendees. Edna Maldonado is the Coding Coordinator for the Practice Management Department and supervises our Coding hotline. Prior to the AUA, Edna was in a urology practice for 20 years. She is a wealth of knowledge when it comes to coding and reimbursement. During her presentation, Edna will discuss strategies for navigating insurance claim denials. “We will cover multiple strategies for managing the claim ...
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This week’s update includes information on our advocacy on U.S. Preventive Services Task Force recommendations, urotrauma, the re-introduced in-office ancillary services bill, and insurance updates. Prostate Cancer Screening: USPSTF Draft Recommendation Issued As I mentioned earlier today, the U.S. Preventive Services Task Force (USPSTF) issued its Draft Recommendation Statement on Screening for Prostate Cancer at 6:00 a.m. this morning. The AUA, who was asked to nominate a member to review the evidence report, has responded publicly to the draft moments later. The draft recommendation, available at www.screeningforprostatecancer.org will be open ...
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Below are a number of insurance issues relevant to urology. Issues range from Evaluation and Management services to updates on telemedicine. National Government Services Evaluation and Management E&M) Update – Tougher Requirements Beginning on July 1, 2017, National Government Services (NGS) will change its documentation requirements for detailed E&M services. Providers will need to include at least six body areas or organ systems to meet the criteria for an expanded problem-focused exam. Currently, providers must document between two-to five-body areas or organ systems. This change will only apply to the 1995 E&M guidelines. For more information ...
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In last's week's Advocacy Snapshot , we shared that Christopher Gonzalez, MD, Chair, AUA Public Policy Council; Patrick McKenna, MD, Chair, AUA Workforce Workgroup; Amanda North, MD, Member of the Leadership Class project on physician burnout; and AUA staff conferenced with the two physician co-leads of the Centers for Medicare & Medicaid Services (CMS) Office of Clinician Engagement.  The goal of the new Office of Clinician Engagement is to drive a coordinated approach to improve the clinician experience. CMS is initially doing a lot of listening and plans on hosting listening sessions around the country around a few priority areas of administrative burden. ...
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In a surprise move on March 24, House Republicans ended consideration of their bill to repeal and replace the Affordable Care Act (ACA) because it lacked enough support for passage. The House floor vote on H.R. 1628, the American Health Care Act (AHCA), was cancelled only hours before it was scheduled to take place. Republicans had intended to repeal former President Obamas signature accomplishment on the seventh anniversary of its signing into law. Congressional leaders had struggled to garner the votes necessary to pass H.R. 1628 since unveiling initial concepts of the plan several weeks ago. Intense negotiations by Speaker Paul Ryan (R-WI-1) attempted ...
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The proceedings paper from the 2016 AUA Quality Improvement Summit on shared decision making and prostate cancer screening is now available. The April 2, 2016, event was co-sponsored by the AUA and Society for Medical Decision Making (SMDM). Speakers included a combination of urologists, primary care providers, nurses, other clinicians, patients, and noted shared decision making researchers. Their discussions throughout the day focused on four primary topics: Shared Decision Making and Decision Aids Values Clarification Decision Coaching Communications The keynote speaker was Harold C. Sox, MD, MACP, with the Patient-Centered Outcomes ...
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The lead topic for this years Health Policy Forum is Telemedicine: State of the Industry and Practical Implications for Urology. The Forum features the American Telemedicine Associations Alexis Gilroy, JD and InTouch Health founder Yulun Wang, PhD, who will advise urologists on e-health topics such as telemedicine, telehealth, and mobile health. The session will take place from 1:00-3:00 p.m. on Sunday, May 14 in Room 205A of the Boston Convention and Exhibition Center. Ms. Gilroy counsels and directs transactions involving venture capital, private equity, debt financing, joint ventures, mergers, acquisitions, management arrangements, physician engagement, ...
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The conference was designed to capture the thoughts, needs, questions and hopes of the urologic community. Twenty-one speakers and panelists representing the U.S. Congress, federal agencies, patient groups and physician organizations took part in the three-day event. It touched on a wide-range of critical topics including the following: Reforming the U.S. Preventive Services Task Force (USPSTF) recommendation process and preserving access to appropriate prostate-specific antigen screening; Repealing the Independent Payment Advisory Board (IPAB) authorized under the Affordable Care Act; Exploring the rising rate of physician burnout; Easing the ...
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Medicaid expansion efforts in Kansas have failed, following a hig- profile political battle between Governor Sam Brownback (R) and the states legislature. The Republican-dominated Kansas House and Senate passed the legislation expanding Medicaid just days after the Republicans attempt to repeal the Affordable Care Act (ACA) stalled in the U.S. Congress. Had the Republican plan passed, it is unlikely that Kansas lawmakers would remain interested in expansion. Gov. Brownback followed through on his promise to veto any legislation expanding the program, sending the bill back to the legislature on April 3. Despite a coalition of moderate Republicans and Democratic ...
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The AUA Coding and Reimbursement Committee (CRC) reviewed a request for guidance on reporting laparoscopic simple prostatectomy for benign prostatic hyperplasia. The CRC consulted all available resources for this procedure and after consideration, advises practices to use 55821 Prostatectomy, perineal, subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy) or 55831 Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); retropubic, subtotal depending how the laparoscopic simple prostatectomy ...
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Make plans now for your team to attend the AUAs next Coding Seminar, to be held July 21-22 in Las Vegas, NV, at the Westin Las Vegas Hotel. Highly respected urology coding experts will update you on coding changes, discussions of common coding questions, and payment denials gathered from the AUA Coding Hotline, and practical exercises to hone the skills of anyone in the practice who is involved with CPT, HCPCS, or ICD coding. The Las Vegas seminar will include the Coding Hotlines Edna Maldonado and Guest Speaker Mark Painter, of PRS Network. To ensure optimum reimbursement for patient care, every practice should send individuals to these essential coding ...
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On May 11, as part of the 2017 AUA Practice Management Conference in Boston, Max Reiboldt, President and Chief Executive Officer at Coker Group, will deliver his presentation, Seven Years after ACA Passage Top Ten Lessons Learned. Max Reiboldt has been a CPA for 44 years and has spent the last 25 years specifically focused on healthcare. Reiboldt has experienced first-hand the incredible changes in the healthcare market, so he wants to present our conference attendees with tangible solutions for their practices. We will present practical examples of urology-specific initiatives to assist in their daily operations but focus upon the changing industry reimbursement ...
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This weeks update shares information on our advocacy on medical liability reform, Independent Payment Advisory Board (IPAB) repeal, and federally funded cancer research, as well as presentations on physician burnout with the Surgical Coalition and Centers for Medicare & Medicaid Services (CMS). IPAB Repeal: Request for In-District Meetings During Upcoming Recess From April 10-21, both the House of Representatives and the Senate will be in recess and working from their district offices. We are asking that urologists reach out to your district offices and set up a meeting with your Representative and Senators to urge them to repeal the IPAB. This is a crucial ...
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Congratulations to Dr. Gerald Sufrin! The Section extends our congratulations to Dr. Gerald Sufrin, who will receive the AUAs Lifetime Achievement Award next month at the Annual Meeting in Boston. This prestigious award will be presented to Dr. Sufrin for his outstanding dedication to urologic education, research and advocacy at the NIH, and as AUA Treasurer during the construction of the new AUA Headquarters building. Dr. Gerald Sufrin completed his urological residency at the Brady Institute under Dr. William W Scott in 1974. After serving as an associate chief cancer research scientist and staff urologist at the Roswell Park Memorial Institute (now the ...
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