This week’s update, which includes information on advancement of the USPSTF Transparency and Accountability Act, the AUA/Alliance of Specialty Medicine’s concerns with the Prescription Drug Pricing Reduction Act, and release of the 2020 Medicare Physician Fee Schedule and Hospital Outpatient/Ambulatory Surgical Center Payment System proposed rules.
Payment Policy: CMS releases 2020 Proposed Rules for MPFS and OPPS/ASC
On July 29, the Centers for Medicare & Medicaid Services issues the proposed rules for the 2020 Medicare Physician Fee Schedule (MPFS) and Hospital Outpatient (OPPS)/Ambulatory Surgical Center (ASC) Payment System. The AUA is actively reviewing the rule, but has developed an “At A Glance” guide to a few important proposed changes of which urologists should be aware. Read more about the rules.
Congressional Outreach: AUA Meets With Members of Congress on USPSTF, Other Health Policy Issues
The AUA continued its efforts to support the U.S. Preventive Services Task Force (USPSTF) Transparency and Accountability Act (H.R. 3534). On July 23, the AUA met with Reps. Donald McEachin (D-VA-4), Ron Kind (D-WI-3), and Linda Sanchez (D-CA-38). Reps. Kind and Sanchez serve on the House Ways & Means Committee, and Congressman McEachin is a leader within the Congressional Black Caucus.
As a reminder, the AUA has an active grassroots campaign supporting H.R. 3534. 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.
On July 24 and 26, the AUA participated in meet & greets with Reps. Dan Kildee (D-MI-5), Jennifer Wexton (D-VA-10), and Lauren Underwood (D-IL-14). Rep. Kildee serves on the House Ways & Means Committee, and this opportunity provided great follow-up to speak with him directly on the USPSTF reform issue after the AUA met with his office the previous week.
Congresswoman Wexton previously served in the Virginia State Senate and is a member of the New Democrats Caucus, which promotes moderate ideals and a balanced budget. A nurse before coming to Congress, Rep. Underwood serves on the House Veterans’ Affairs Committee, and has expressed interest in reducing the physician workforce shortage as well as addressing the issue of burnout within the medical community.
Political Update: AUAPAC Supports Representatives on House Energy & Commerce Committee
Between July 16 and 25, AUAPAC participated in fundraisers for Reps. Frank Pallone (D-NJ-6), Markwayne Mullin (R-OK-2), and Raul Ruiz, MD (D-CA-36), who all serve on the House Energy & Commerce (E&C) Committee. Congressman Pallone is the chair of the full committee. Along with serving on E&C, Rep. Mullin also co-chairs the Congressional Men’s Health Caucus. In addition, Dr. Ruiz has been a champion on issues like repeal of the Independent Payment Advisory Board, increased funding for graduate medical education residency slots, and fought to include an arbitration process in the House legislation to end surprise billing.
Medicare Drug Pricing Legislation: AUA, Alliance of Specialty Medicine (ASM) Weigh in on Average Sales Price Reporting
On July 25, the AUA joined the Alliance of Specialty Medicine, to express concerns with the recently proposed bipartisan Prescription Drug Pricing Reduction Act (PDPRA). Introduced by Chairman Chuck Grassley (R-IA) and Ranking Member Ron Wyden (D-OR) of the Senate Finance Committee, the proposal is intended to increase transparency into pharmacy benefit manager practices and manufacturer drug pricing decisions, improve how Medicare calculates Part B prescription drug payment amounts in an effort to lower spending and beneficiary out-of-pocket costs, and eliminate excess Part B drug payments that drive up beneficiary and program costs, among other things. The Alliance is concerned about the bill’s requirement to include the value of manufacturer drug coupons in Average Sales Price (ASP) reporting. This provision could result in further cuts to physicians that administer drugs in their offices, increase the gap between what small and rural practices pay to acquire the drugs for their patients and Medicare reimbursement, and possibly decrease access for many patients to certain drugs and medications.
There continues to be a major focus by lawmakers on reducing out-of-pocket costs that Americans pay for healthcare services. As this particular proposal continues to move forward, we will keep you updated.
Insurance Updates: Week of July 29, 2019
Each week the AUA publishes weekly updates on the latest insurance issues pertaining to urology. This week’s update includes important information regarding Xtandi, prostatic urethral lift, posterior tibial nerve stimulation, assistant surgeon payments, brachytherapy, and telemedicine services. Read more here.
Partner Outreach to Advance AUA Advocacy Efforts
In effort to identify areas of alignment among the AUA’s advocacy initiatives and its partners’ legislative priorities, the AUA initiated meetings with met with Men’s Health Network (MHN) and RESOLVE: The National Infertility Association. MHN is actively working on the introduction of a bipartisan bill that will establish an Office of Men's Health under the Department of Health and Human Services. MHN discussed this initiative at the 2018 AUA Advocacy Summit and received support from the urology community. Additionally, MHN sponsors Men’s Health Month in June where the AUA partnered in a Twitter Chat to raise awareness about men’s health. Additionally, MHN is an active member of the Bladder Health Alliance and supports efforts to promote awareness about bladder health conditions through social media channels. You can follow Men’s Health network on Twitter here.
As noted in the May 7 PPC update, the AUA participated in a congressional fly-in co-hosted by RESOLVE and the American Society for Reproductive Medicine to discuss patient access to infertility care, protecting the right to build a family, and fertility preservation. As a follow up to this effort, the AUA met with RESOLVE on July 25 to discuss additional ways that the AUA and RESOLVE can collaborate on state advocacy efforts and work to formulate the upcoming agenda for their 2020 advocacy day and fly-in. Follow RESOLVE on Twitter.