This week's update includes information on more than a dozen meetings with congressional offices gathering support for the USPSTF Transparency & Accountability Act, patient and research advocacy news and our support of H.R. 3107, the Improving Seniors' Timely Access to Care Act.We are also excited this week to launch our first Advocacy Update episode of the AUA's Inside Tract podcast.
U.S. Election News: North Carolina Urologist Greg Murphy Advances to General Election!
Congratulations to AUA member Dr. Greg Murphy for his win on July 9 in North Carolina's special primary election for the open seat to represent the state's 3rd District in the U.S. House of Representatives. Read more about the election.
U.S. Preventive Services Task Force Reform (USPSTF): AUA Advances House Bill through Congressional Outreach
Now that the USPSTF Transparency and Accountability Act has been reintroduced in the House of Representatives, the AUA has initiated meetings with members of the Ways & Means and Energy & Commerce Committees – the two committees with jurisdiction on health policy matters in the House – to garner support for the bill. Between July 1 - 12, the AUA met with Reps. Mike Thompson (D-CA-5), Brian Higgins (D-NY-26), Steve Horsford (NV-04), Brad Wenstrup, MD (R-OH-2), Terri Sewell (D-AL-07), Drew Ferguson (R-GA-03) Jackie Walorski (R-IN-02), Darin LaHood (R-IL-18), Lloyd Doggett (D-TX-35), Jodey Arrington (R-TX- 19), Suzan DelBene (D-WA-1), and Brad Schneider (D-IL-10) on the Ways & Means Committee. And, Reps. Ben Ray Lujan (D-NM-3), Eliot Engel (D-NY-16), Larry Bucshon, MD (R-IN-8), Debbie Dingell (D-MI-12) on the Energy & Commerce Health Subcommittee. The AUA also has confirmed that Rep. Terri Sewell (D-AL-07) – on the Ways & Means Health Subcommittee – has signed on as a cosponsor following the AUA’s meeting.
As a reminder, the AUA has an active grassroots campaign supporting the USPSTF Transparency and Accountability Act. If you have not done so, please contact your representative (our Phone2Action system allows you to send both letters and customized tweets) and urge them to support the bill. We also ask that your colleagues do the same.
Freshman Outreach: AUA Meets with Rep. Max Rose
On July 11, the AUA met with freshman member Rep. Max Rose (D-NY-11). Prior to Congress, he served as chief-of-staff at Brightpoint Health, a health nonprofit operator of medical clinics in Staten Island. Rep. Rose, a veteran of Operation Enduring Freedom in Afghanistan, serves on of the House Veteran’s Affairs Subcommittee on Health, is a member of the Problem Solvers Caucus and the New Democrat Coalition, and he has expressed interested in infertility issues affecting veterans and their families.
Prior Authorization: AUA Signs AMA Letter in Support of H.R. 3107
On July 8, the AUA signed onto an American Medical Association (AMA) letter in support of the Improving Seniors’ Timely Access to Care Act (H.R. 3107). The bill was introduced by Reps. Suzan DelBene (D-WA-1), Mike Kelly (R-PA-16), Roger Marshall, MD (R-KS-1) and Ami Bera, MD (D-CA-7) to streamline prior authorization processes in Medicare Advantage plans. Specifically, the bill would:
- Create an electronic prior authorization program, including the electronic transmission of prior authorization requests and responses and a real-time process for items and services that are routinely approved;
- Improve transparency by requiring plans to report to CMS on the extent of their use of prior authorization and the rate of approvals or denials;
- Require plans to adopt transparent prior authorization programs that are reviewed annually, adhere to evidence-based medical guidelines, and include continuity of care for individuals transitioning between coverage policies to minimize any disruption in care;
- Hold plans accountable for making timely prior authorization determinations and to provide rationales for denials; and
- Prohibit additional prior authorization for medically-necessary services performed during a surgical or invasive procedure that already received, or did not initially require, prior authorization.
Medical Liability Reform: ACCESS Act Introduced in the House
On July 9, the Accessible Care by Curbing Excessive Lawsuits (ACCESS) Act, H.R. 3656, was introduced by Reps. Richard Hudson (R-NC-8), Roger Marshall, MD (R-KS-1), and Larry Buschon, MD (R-IN-8). Read more about this legislation.
State Advocacy Update: California Sees “Surprise Billing” Legislation Stall; California Prostate Cancer Awareness Month Introduced
California postpones action on legislation addressing unexpected medical bills, and takes steps to promote prostate cancer awareness this September. Read more.
Patient and Research Advocacy: Fiscal Year 2020 Appropriations Update and Partner Meetings
On July 8, the AUA participated in One Voice Against Cancer’s (OVAC) monthly stakeholder meeting. Conversation centralized around Fiscal Year 2020 Appropriations updates and upcoming grassroots initiatives. It was noted that the House minibus (H.R. 2740) included many of OVAC’s priorities including a $2 billion increase for National Institutes of Health (NIH), $300 million increase for National Cancer Institute (NCI) and an almost $40 million funding increase for cancer programs at the Centers for Disease Control and Prevention (CDC). Grassroots plans include a Twitter “Online Day of Action” in September where stakeholders will use synergized messaging to convey targeted messages to Appropriators. Specific asks and messaging will be available and shared in late August. The AUA is participating in a workgroup to develop an OVAC-sponsored “Cancer 101” Capitol Hill Briefing in late October that will raise awareness about the continuum of cancer care. We will keep you apprised of the specific topics and meeting logistics as they are available. As background, OVAC is a coalition of over 40 non-profit groups who join together to deliver a unified message to the White House and Congress on increased cancer-related appropriations funding.
On July 9, the AUA met with advocacy partner RetireSafe to discuss areas of alignment on advocacy and legislation issues. RetireSafe’s priorities include state importation legislation, health education in rural areas and devoting time on Capitol Hill advocating for general access to care issues. Potential areas of collaboration include joint meetings on Capitol Hill to advocate for improved patient access in rural communities and securing and protecting funds for research. RetireSafe participated in the AUA’s Patient Advocacy Program at Annual Meeting and recently joined the Bladder Health Alliance. The AUA will continue outreach to patient advocacy partners and keep you apprised of additional collaboration opportunities.
Insurance Updates: Week of July 15, 2019
Each week, the AUA publishes weekly updates on the latest insurance issues pertaining to urology. This week’s update includes important information from Moda Health and its updated policies concerning Botox, Xeomin, and Dysport. United Healthcare also reported updates to its policy related to its medical benefit injectable medication Prior Authorization process specialty drugs. There also is information regarding a recent name change and code update for its for Evaluation and Management (E&M) policy, as well. Read more here.
Updates: First Friday Clinician Outreach Meeting, July 12, 2019
The Centers for Medicare & Medicaid Services (CMS) July 12 Clinician Outreach Meeting focused on the newly published Open Payments 2018 Data, the Inpatient Rehabilitation Facility (IRF) Appeals Settlement Initiative, and the Electronic Health Record (EHR) Reporting Program.
Read more here.
Practice Management: Evaluation & Management Auditing Service
Would you like to improve the financial health of your practice? If so, the AUA's Evaluation & Management Audit Service is an essential option for your team. Designed for evaluation and management (E&M) services and minor procedures only, the Evaluation & Management Audit Service provides a mechanism for educating providers on documentation guidelines, ensuring all services are supported, and all appropriate revenue is captured. There are multiple benefits to participating in this program:
- Our audit service is urology-specific and is being performed by experts in the field.
- All auditing is done at the AUA. No medical records are outsourced to a third party.
- The service also offers your practice an opportunity to identify reimbursement deficiencies and increase revenue by spotting under-coding and unbilled services.
Slots for this program are limited and will be filled based on submission date and availability. Visit the AUA's Evaluation & Management Service page to learn more about using this service for your practice