Blogs

Insurance Updates: November 21-28, 2022 Each week, the AUA publishes weekly updates on the latest insurance issues pertaining to urology. This week’s update includes the release of policies regarding percutaneous tibial nerve stimulation, focal treatments for prostate cancer, and whole gland cryoablation of prostate cancer. BCBS Alabama BCBS Alabama issues revisions to protein biomarkers for diagnosis and risk assessment of prostate cancer. Revisions include a change to coding, added code 0359U, effective 01/01/2023. Read the update. BCBS Mississippi BCBS Mississippi issues revisions to coding for Percutaneous Tibial Nerve Stimulation. The ...
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During the 2022 mid-term elections, voters across all fifty states took to the polls on November 8 to cast ballots. This election included races for all 435 House seats, 35 Senate seats, and countless state-level officials. As of November 15, two Senate and numerous U.S. House races are still undecided. The Democratic Party will maintain control the U.S. Senate; however, the majority in the House of Representatives remains undetermined for the 118th Congress. Thirty eight of the 40 AUAPAC recipients sought reelection. Twenty nine out of a possible 30 House candidates were victorious, with all races decided. For the 2021-2022 election cycle, AUAPAC has a ...
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On November 12-15, AUA Delegates – Hans Arora, MD; Jason Jameson, MD; Richard Pelman, MD; and AUA Resident/Fellow Section Delegate Ruchika Talwar, MD represented the AUA at the 2022 American Medical Association (AMA) House of Delegates (HoD) Interim Meeting. The AMA HoD is the principal policy-making body of the AMA. It represents the views and interests of a diverse group of member physicians from more than 170 societies. These delegates meet twice a year to establish policy on health, medical, professional and governance matters. The delegates first participated in a variety of specialty caucus pre-meetings, including those hosted by the Surgical Caucus ...
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Day 4 Blog (Tuesday, November 15) AUA Delegates, Drs. Hans Arora and Richard Pelman, AUA Alternate Delegate Dr. Jason Jameson; and AUA Resident/Fellow Section Delegate, Dr. Ruchika Talwar joined more than 600 physicians at the American Medical Association (AMA) House of Delegates (HoD) 2022 Interim Meeting to consider resolutions and reports covering clinical practice, payment, medical education, and public health topics. View our previous updates from the meeting. On Tuesday, the AUA delegates spent one final day in the general session where the House debated and voted on various measures relating to Public Health, Reference Committee on Amendments to ...
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Day 3 Blog (Monday, November 14) AUA Delegates, Drs. Hans Arora and Richard Pelman, AUA Alternate Delegate Dr. Jason Jameson and AUA Resident/Fellow Section Delegate, Dr. Ruchika Talwar joined more than 600 other physicians at the American Medical Association (AMA) House of Delegates (HoD) 2022 Interim Meeting to consider resolutions and reports covering clinical practice, payment, medical education and public health topics. View our previous updates from the meeting. On Monday, the AUA delegates spent the day in the general session where the House debated and voted on various measures relating to AMA Governance and Finance, Medical Practice, and Legislation. ...
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Day 2 Blog (Sunday, November 13) AUA Delegates, Drs. Hans Arora and Richard Pelman, AUA Alternate Delegate Dr. Jason Jameson and AUA Resident/Fellow Section Delegate, Dr. Ruchika Talwar joined hundreds of physicians at the American Medical Association (AMA) House of Delegates (HoD) 2022 Interim Meeting to consider resolutions and reports covering clinical practice, payment, medical education and public health topics. Top issues at the meeting include ongoing physician workforce shortages, healthcare disparities, telemedicine expansion, scope of practice and medical licensing. On Sunday, the AUA delegation participated in multiple reference committee meetings ...
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Day 1 Blog (Saturday, November 12) AUA Delegates Drs. Hans Arora and Richard Pelman, AUA Alternate Delegate Dr. Jason Jameson and AUA Resident/Fellow Section Delegate Dr. Ruchika Talwar joined hundreds of physicians at the American Medical Association (AMA) House of Delegates (HoD) 2022 Interim Meeting to consider resolutions and reports covering clinical practice, payment, medical education, and public health topics. Top issues at the meeting include ongoing physician workforce shortages, healthcare disparities, telemedicine expansion, scope of practice, and medical licensing. On Saturday morning, AUA delegates participated in a variety of specialty caucus ...
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State Advocacy Update Florida Medical and Osteopathic Boards Propose Rules to Restrict Gender Affirming Care for Minors Florida’s medical and osteopathic boards voted to adopt a new standard of care that forbids physicians from prescribing puberty blockers, hormones or performing surgeries until their transgender patients are 18. Physicians currently providing gender-affirming care to children are exempt. Florida is the first state to ban gender-affirming care through the Medical and Osteopathic Boards. In August, a lawyer for the Florida Department of Health acknowledged the state had not received any patient complains about gender-affirming ...
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The American Urological Association’s Delegates – Hans Arora, MD, Richard Pelman, MD, Jason Jameson, MD and Ruchika Talwar, MD, will join hundreds of physicians at the American Medical Association (AMA) House of Delegates 2022 Interim Meeting to consider resolutions and reports covering clinical practice, payment, medical education and public health topics. Regular updates will be posted to the Policy & Advocacy Brief blog over the course of the meeting. As a reminder, the AMA HoD is the principal policy-making body of the AMA. It represents the views and interests of a diverse group of member physicians from more than 170 societies. These delegates ...
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Insurance Updates: November 9, 2022 Each week, the AUA publishes weekly updates on the latest insurance issues pertaining to urology. This week’s update includes the release of policies regarding prostatic urethral lift and decipher biopsy prostate cancer classifier assay. BCBS Arizona BCBS Arizona issued its new Prostatic Urethral Lift Policy stating prostatic urethral lift may be considered medically necessary when criteria are met. Read the update. BCBS Rhode Island BCBS Rhode Island published its draft Therapeutic Radiopharmaceuticals for Prostate Cancer Policy, effective January 1, 2023, stating therapeutic radiopharmaceuticals for ...
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State Advocacy Update Legislation Limiting State Medical Boards’ Authority The AUA and the Federation of State Medical Boards (FSMB) is monitoring a troubling legislative trend around the country aimed at limiting a state medical boards’ authority to investigate patient harm in relation to COVID-19. This year, 61 bills were introduced to impede licensing boards’ regulatory capabilities in response to COVID-19 treatment in 25 states. In addition, 10 states introduced 13 bills to explicitly allow for the off-label use of prescription drugs, such as ivermectin and hydroxychloroquine. As of October 26, six of those bills are active and five have been signed ...
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Representatives Ami Bera, MD (D-CA-7) and Larry Buschon, MD (R-IN-8), along with their colleagues, requested feedback from stakeholders on actions Congress should take to stabilize the Medicare payment system while ensuring successful value-based care incentives are in place. Specifically, the RFI asked that responses should address the effectiveness of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA); regulatory, statutory, and implementation barriers that need to be addressed for MACRA to fulfill its purpose of increasing value in the US health care system; how to increase provider participation in value-based payment models; and provide recommendations ...
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On November 1 st , the Centers for Medicare & Medicaid Services (CMS) released the Medicare Physician Fee Schedule (MPFS) final rule for CY 2023 (CMS-1770-F). This rule updates payment policies and payment rates for Part B services furnished under the MPFS, as well as makes changes to the Quality Payment Program (QPP). A pre-publication version of the rule can be found here . A press release and fact sheet are also available. Conversion Factor: The CY 2023 Medicare conversion factor (CF) is set at $33.06, a decrease of 4.5% from the 2022 CF of $34.61. The decrease is mainly the result of the expiration of a 3% increase funded by Congress through ...
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Representatives Bera and Buschon, along with their colleagues requested feedback from stakeholders on actions Congress should take to stabilize the Medicare payment system while ensuring successful value-based care incentives are in place. Specifically, the RFI asked that responses should address the effectiveness of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA); regulatory, statutory, and implementation barriers that need to be addressed for MACRA to fulfill its purpose of increasing value in the US health care system; how to increase provider participation in value-based payment models; and provide recommendations to improve the Merit –Based ...
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Insurance Updates: November 1, 2022 Each week, the AUA publishes weekly updates on the latest insurance issues pertaining to urology. This week’s update includes the release of policies regarding prostatic urethral lift and decipher biopsy prostate cancer classifier assay. BCBS Arizona BCBS Arizona issued its new Prostatic Urethral Lift Policy stating prostatic urethral lift may be considered medically necessary when criteria are met. Read the update. BCBS Rhode Island BCBS Rhode Island published its draft Therapeutic Radiopharmaceuticals for Prostate Cancer Policy, effective January 1, 2023, stating therapeutic radiopharmaceuticals for ...
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State Advocacy Update: New Jersey introduces network adequacy bill – AUA promotes efforts to support adequate insurance networks. For information about bills the AUA is tracking in your state, please contact AUA State Advocacy Manager Catherine Hendricks at CHendricks@AUAnet.org . Check out our interactive map on the AUA State Advocacy Webpage . New Jersey S. 3216 – Insurance Introduced by Senator Paul Sarlo (D), S. 3216 requires health insurance carriers to provide an adequate network of physicians to ensure covered persons reside no more than: a 20 minute drive or 10 miles from a primary care provider; 30 minute drive or 15 ...
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On October 11, the AUA joined with ZERO – The End of Prostate Cancer, along with more than 20 patient advocacy organizations and other stakeholders from across the prostate cancer community, in sending a letter of support to Representatives Bobby Rush (D-IL-1) and Larry Buschon, MD (R-IN-8) for the Prostate Specific Antigen Screening for High-risk Insured Men Act (PSA) for HIM Act (H.R. 1176). The PSA for HIM Act waives deductibles, copayments and coinsurances for prostate cancer screenings for those with a family history of prostate cancer or who are African-American. The letter aims to show broad organizational support for the bill and stir new interest ...
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Insurance Updates: October 25 Each week, the AUA publishes weekly updates on the latest insurance issues pertaining to urology. This week’s update includes the release of policies regarding pelvic floor stimulation and gene-based tests for screening, detection and/or management of prostate cancer. BCBS Arizona BCBS Arizona reviewed its Pelvic Floor Stimulation as a Treatment of Urinary and Fecal Incontinence Policy updating the list of experimental and investigational criteria to add lack of final approval from the appropriate governmental regulatory bodies to the list of options. Read the update. BCBS Mississippi BCBS Mississippi reviewed ...
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Insurance Updates: October 19 Each week, the AUA publishes weekly updates on the latest insurance issues pertaining to urology. This week’s update includes the release of policies regarding sexual dysfunction and gene-based testing for prostate cancer. BCBS Arizona BCBS Arizona archived its Water Jet Hydrodissection for the Treatment of Benign Prostatic Hypertrophy Policy. Per medical policy review of August 30, this guideline has been replaced. Refer to BCBSAZ Evidence-Based Criteria, Transurethral Water Vapor Thermal Therapy and Transurethral Water Jet Ablation (Aquablation) for Benign Prostatic Hypertrophy. The replacement policy not yet available ...
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State Advocacy Update Oregon Medical Board Approves Chaperone Rule Announced last week, the Oregon Medical Board (OMB) adopted the medical chaperone rule, OAR 847-010-0130 , requiring licensees to offer a trained chaperone for all breast, genital, and rectal examinations. The rule will become enforceable effective on July 1, 2023. A list of Frequently Asked Questions and additional information is available on the OMB’s Medical Chaperone webpage , including information about approved training courses and the process for requesting course approval. For information about bills the AUA is tracking in your state, please contact AUA State ...
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