This week’s update includes information on a reintroduction of a resolution that would support the access to medical device treatments for male incontinence and impotence, the AUA and the Alliance of Specialty Medicine’s comments to Senate Health, Education, Labor and Pensions Committee on addressing the opioid crisis, and our participation in a Congressional roundtable on red tape relief.
Full Continuum of Care: Prostate Cancer Quality of Life Resolution Reintroduced
On April 10, Rep. Erik Paulsen (R-MN-3) reintroduced his measure on supporting the quality of life of prostate cancer patients. The resolution (H. Res. 812) currently has one cosponsor, Rep. Donald Payne, Jr. (D-NJ-10), who is the co-chair of the Men’s Health Caucus and leading the effort on establishing an Office of Men’s Health in the Department of Health and Human Services. Based on the AUA’s review, the measure appears to be identical to the 2016 version, with updated prostate cancer statistics.
The main tenet of H. Res. 812 states: It is the sense of the House of Representatives that Congress should protect Medicare or Veterans’ Administration benefits for medical device treatments for male incontinence and impotence that result from treatment for prostate cancer, diabetes, cardiovascular disease, Parkinson’s disease, or multiple sclerosis and that any such coverage decisions should be based on data and made after careful review by medical experts with a critical eye toward the impact of coverage decisions on the Medicare and Veterans’ Administration populations.
The AUA will begin working on collecting cosponsors from other lawmakers in the U.S. House of Representatives. Another potential strategy will be to find a champion in the U.S. Senate so that lawmakers in that chamber have a way to signal their support for this issue. As a reminder, this measure is non-binding and does not carry the force of law. Rather, it is designed to spur a discussion with congressional offices, educate them, raise awareness, and build a network of lawmakers that support the full continuum of care for prostate cancer survivors.
Opioid Crisis: Congressional Update
On April 11, the Senate Health, Education, Labor and Pensions (HELP) Committee held a hearing on proposed legislation – the Opioid Crisis Response Act – to address the ongoing opioid epidemic. During the hearing, Chairman Lamar Alexander (R-TN) stated his intentions to have this bipartisan legislation on the floor of the full Senate by the end of April. To receive a full summary of the event, please contact Joshua Webster at jwebster@AUAnet.org.
In addition, attached is a letter to the HELP Committee about this proposed opioid legislation from the Alliance of Specialty Medicine – of which the AUA is a member. The letter is similar to the one the Alliance and AUA sent to the House Ways & Means Committee in March, focusing on overprescribing and data tracking, communication and education for both the patient and the prescriber, and treatment options/concerns to consider. Some key takeaways include ensuring that state prescription drug monitoring programs can be integrated into electronic health records in a user-friendly fashion that will not increase administrative burden, and improving coverage for non-opioid analgesics and other alternative pain management and treatment options. As efforts to address the opioid crisis continue to advance in both the House and the Senate, the AUA will continue to keep you updated.
Reminder: Schedule Time to Visit the Patient Advocacy Hub at AUA2018
This year in San Francisco, don’t forget to visit the Patient Advocacy Hub at the AUA Annual Meeting. Visiting the Hub allows for a continuation of cultivating relationships with AUA’s advocacy partners.
The goal of the Hub is to promote collaboration among urologic patient advocacy organizations, physicians and researchers in effort to effectively promote urologic advocacy initiatives that enhance patient access to healthcare. The Hub’s interactive design facilitates valuable dialogue among the urologic community including patients, physicians, and researchers.
There are 20 confirmed organizations participating in the Patient Advocacy Hub at AUA2018 who represent all facets of the urology community. This represents five more groups than AUA2017. The Hub will be open May 18 and 19 and will follow a daily schedule divided into 11 urologic-themed hours (details available here).
Top Takeaways from the CMS Clinician Outreach Call
Top takeaways from Centers for Medicare & Medicaid Services (CMS) April 6 Clinician Outreach Meeting focused on the Patients over Paperwork Initiative and New Medicare Card Update.
Patients over Paperwork Initiative
- CMS has established an internal process to evaluate and streamline regulations with a goal to reduce unnecessary burden, increase efficiencies, and improve the beneficiary experience.
- Patients over Paperwork aims to increase the number of customers, decrease the hours and dollars clinicians and providers spend on CMS-mandated compliance, and increase the proportion of tasks that CMS customers can do in a completely digital way.
For further information on the Patient over Paperwork Initiative, click here. CMS also publishes a monthly Patients over Paperwork newsletter.
New Medicare Card Update
- CMS started mailing newly designed Medicare cards with the new Medicare Beneficiary Identifier (MBI), or Medicare Number. People enrolling in Medicare for the first time will be among the first to get the new cards, no matter where they live. Current Medicare beneficiaries will get their new cards on a rolling basis. CMS will continue to accept the Health Insurance Claim Number (HICN) through the transition period. Healthcare providers and people with Medicare will be able to use secure look-up tools that will allow quick access to the new Medicare numbers when needed.
- CMS is working on making processes even better by using the highest levels of fraud protection when mailing new cards to current Medicare beneficiaries. CMS continuously adjusted and improved their mailing strategy to ensure that cards are being mailed to accurate addresses and that they’re protecting current Medicare beneficiaries and their personal information in every way possible.
For more information, click here. The next Clinician Outreach Meeting is May 4, 2018.
Insurance Updates: Week of April 16, 2018
The AUA is publishing weekly updates on the latest insurance issues pertaining to urology, including information on CareFirst Blue Cross’s new technology assessment update and Blue Cross Blue Shield of North Dakota’s pharmacy update. Read more here.
Medicare Red Tape Relief: AUA Attends House Ways and Means Subcommittee Roundtable
On April 12, the American Urological Association participated in an Alliance of Specialty Medicine Policy Roundtable with the Honorable Peter Roskam, Chairman of the House Ways and Means Subcommittee on Health, to address key issues affecting specialty medicine. The Alliance raised several recommendations for the Chairman’s consideration, including the following:
- To maintain a viable Medicare fee-for-service system and to reduce the burden of the Merit-based Incentive Payment System (MIPS)
- To adopt legislation to eliminate the separate and redundant requirements to consult Appropriate Use Criteria enacted under the Protecting Access to Medicare Act of 2014 (PAMA) and instead incorporate related requirements under the Medicare Quality Payment Program (QPP)
- To support and advance H.R. 3635, the Local Coverage Determination Clarification Act, which would revise the process by which Medicare administrative contractors (MACs) issue and reconsider local coverage determinations (LCDs)
- To convene an oversight hearing to investigate the use of prior authorization and utilization management practices by Medicare Advantage organizations and Part D plans
The Alliance of Specialty Medicine plans to convene a work group to engage in follow up with the Chairman on these and other related issues.
Practice Management: PMC Highlight Series
This week, the AUA will release a new installment of our content series, PMC Highlights, featuring Dr. Ellis M. Knight, Senior VP at Coker Group. His presentation “Principles of Patient Engagement and Satisfaction” will teach attendees how to differentiate between quality, value, and patient experience and how to improve overall patient satisfaction. The PMC Highlight series offers AUA members with a preview of the excellent presentations and events they can expect at the 2018 AUA Practice Management Conference in San Francisco, California. Find out more information about all of the presenters and events at this year’s Practice Management Conference here.