This week’s update includes information on the AUA’s Congressional meeting on step therapy as well as highlights from the Centers for Medicare & Medicaid Services’ Clinician Outreach meeting.
Step Therapy: AUA, Regulatory Relief Coalition Congressional Meeting
On December 4, the AUA met with the office of Sen. Chuck Grassley (R-IA) as part of our ongoing efforts with the Regulatory Relief Coalition, which is a group of provider organizations looking to ease the various regulatory burdens being placed on physicians. The meeting addressed the issue of step therapy in the Medicare Advantage program. As the incoming chair of the Senate Finance Committee, Sen. Grassley is in an opportune position to influence the Centers for Medicare & Medicaid Services and express on the impact step therapy has on patient access, interaction with physicians, and its effect on physician morale. The AUA will continue to keep you updated on the coalition efforts around this issue and any changes that it may bring. If you have any questions, please contact Quardricos Driskell at QDriskell@AUAnet.org.
Patient and Research Advocacy Update
On December 6, the AUA attended the Partnership to Improve Patient Care’s (PIPC) Annual Forum: Building a Patient-Centered Health System. The meeting focused on alternative, evidence-based strategies for making health care decisions that reflect patient values. Panelists included representatives from the Innovation and Value Initiative, University of Maryland Baltimore School of Pharmacy, Avalere, National Health Council, National Patient Advocate Foundation, and Patient-Centered Outcomes Research Institute (PCORI).
Of note was a call for advocates to take action and talk to lawmakers about reauthorizing funding for PCORI in 2019. Specific legislation to authorize this funding is expected to be introduced in January and the AUA will keep you apprised of our advocacy efforts to promote legislation when it is introduced. To learn more about PCORI and the research funded by their programs you can visit this site.
Clinician Outreach Meeting: Top Takeaways
Here are top takeaways from Centers for Medicare & Medicaid Services (CMS) December 7 Clinician Outreach Meeting, including an update on the New Medicare card.
New Medicare Card Updates and Discussion
- CMS is in the process of sending out the final wave of mailings with new Medicare cards. CMS published a Q&A for health care providers and office managers to learn about the new system. CMS created a portal for each Medicare Administrative Contractor (MAC) for providers to access and verify beneficiary information, including new Medicare Beneficiary Identifier (MBI), review claim submissions, fee schedules and local coverage determinations. The portals are now live. The old (Medicare beneficiary) Health Insurance Claim Number (HICN) will still work through the entire year of 2019 while CMS transitions to the new MBI.
Procedure Price Lookup and other news
- The new procedure price lookup tool will compare prices for procedures that are performed in both the ASC and the hospital outpatient departments. For more information, click on the following links:
- CMS is currently working to address Medicare Advantage issues, and there will be more information to come in the near future.
The next meeting is January 4, 2019.
Practice Management: Registration for the 2019 Practice Management Conference is Now Open!
Registration is now open for the 2019 Practice Management Conference. The conference will be held on May 2-3, 2019 in Chicago, IL at the McCormick Convention Center (second level of the North Building). Our conference attendees will enjoy valuable presentations on a wide range of practice management topics such as the role of urology in clinically integrated networks, the use of scribes in urology practices, and an update on USP800 Regulation. Next year’s attendees have even more to look forward to, as all conference attendees will have free access to the AUA’s exhibit hall with paid registration for the Practice Management Conference.
Register now for the 2019 Practice Management Conference and save with our early bird discount.
Insurance Updates: Week of December 10, 2018
Each week, the AUA publishes weekly updates on the latest insurance issues pertaining to urology. This week’s update includes information on prior authorization policy for Eligard with Oxford United Healthcare (UHC), as well as information for Virginia Anthem Blue Cross’s Modifier 79 policy. Virginia Anthem Blue Cross has also issued new requirements for claims requiring additional documentation. Read more.