Blogs

Insurance Updates:  May 5, 2021 Each week, the AUA publishes weekly updates on the latest insurance issues pertaining to urology. This week’s update includes the release of COVID-19 and telehealth/telemedicine specific newsletters and policy updates. Blue Cross Blue Shield (BCBS) South Carolina reviewed its Gene Expression Profiling and Protein Biomarkers for Prostate Cancer Management and Serum Tumor Markers for Malignancies Policies. COVID-19 Updates: Aetna Aetna published its COVID 19 Billing and Coding News (Commercial, Medicare) provider bulletin, announcing updated information regarding that all claims that are based on Medicare payment ...
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On April 27, the AUA signed onto a letter to U.S. House of Representatives and Senate leaders urging Congress to provide $3 billion in funding to negate expected reductions to the Medicare Physician Fee Schedule’s conversion factor. Actions by Congress in the final days of 2020 in passing annual appropriation legislation, included a similar measure to prevent imminent cuts to physician reimbursement. The AUA, along with many other associations and medical societies, is seeking a long-term solution to the continual threat of cuts to the Medicare Physician Fee Schedule due to budget neutrality, but a stop-gap measure is needed to prevent those cuts from occurring ...
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Last week, the AUA joined the Defense Health Research Consortium (DHRC) in circulating a Dear Colleague letter asking lawmakers to continue their support of the Congressionally Directed Medical Research Programs (CDMRP). The DHRC addressed the letter to Representative Betty McCollum (D-MN-04), Chairwoman of the House Appropriations Defense Subcommittee, and Representative Ken Calvert (R-CA-42), Ranking Member of the same subcommittee. The DHRC is a coalition of patient advocacy organizations, medical provider groups including the AUA, veterans’ organizations, research advocacy groups, and private sector interests. The letter was signed by more than fifty members ...
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On April 28, the AUA, along with its colleagues in the Alliance of Specialty Medicine, participated in a meet and greet with Representative Ann Kuster (D-NH-02). She is a member of the House Energy & Commerce Subcommittee on Health, which is one of two main committees that oversee health policy in the House. She strongly supports various issues of importance to the AUA and its members, including increasing federal biomedical research funding for the National Institutes of Health, addressing the physician workforce shortage, and continuing to expand access to telemedicine whenever possible.
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On April 27, the AUA met with staff in the offices of Representatives Ronny Jackson, MD (R-TX-13) and Scott Franklin (R-FL-15). Dr. Ronny Jackson, in particular, is an emergency medical physician and retired U.S. Navy rear admiral who served in the White House Medical Unit under Presidents George W. Bush, Barack Obama, and Donald Trump. Both members have interest in the AUA-led Veteran’s Prostate Cancer Treatment and Research Act (H.R. 6092 in the last Congress). As a reminder, the bill directs the Department of Veterans Affairs to establish a clinical pathway for prostate cancer, designed in collaboration with disciplines across the public and private sector, ...
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As you are undoubtedly aware, telemedicine adoption has greatly accelerated within all specialties due to the COVID-19 pandemic. Over 70% of urologists adopted some form of telemedicine usage during the ongoing public health emergency. In 2016 the AUA Telehealth Workgroup released a white paper on Telemedicine in Urology, based on the state of adoption and usage at the time. With this unprecedented pandemic situation and increase in adoption also comes an influx of data and understanding. Telemedicine experiences in urology span the spectrum of the practice; from new consultations and surgery to virtual house calls and staff supervision.   The current ...
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Insurance Updates:  April 28, 2021 Each week, the AUA publishes weekly updates on the latest insurance issues pertaining to urology. This week’s update includes the release of COVID-19 and telehealth/telemedicine specific newsletters and policy updates. Blue Cross Blue Shield (BCBS) Alabama published its new Treatment of Benign Prostatic Hyperplasia Policy. Additionally, Aetna updated its Incontinence Policy. COVID-19 Updates: Aetna Aetna published its COVID 19 Telemedicine News (Commercial) provider bulletin announcing for Individual Aetna Medicare Advantage members, copays are waived for in-network telehealth visits for primary care through ...
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Earlier this year, Representative Phil Cortez (D) introduced House Bill 3951 to prohibit cost-sharing for prostate cancer screenings specifically tailored to apply to men over the age of 50 and men over the age of 40 with a family history of prostate cancer or another risk factor for prostate cancer. On April 20, the Texas House Insurance Committee held a hearing on the measure where former Science & Quality Council Chair J. Stuart Wolf, Jr, MD, FACS, Chief, Division of Surgical Subspecialties in the Department of Surgery and Perioperative Care at the Dell Medical School, University of Texas at Austin, testified in support of HB 3951 for the Texas Urological ...
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Last week, the AUA participated in the Alliance for Connected Care Virtual Telehealth Summit to discuss policy and operational issues related to virtual care. Topics included federal and state level policy and advocacy around current procedural terminology codes for telehealth, health savings accounts, prescribing of controlled substances, the Telehealth Modernization Act, the CONNECT for Health Act, access to broadband as well as data dispelling overutilization and fraud perceptions and state waiving licensure. The group further discussed how virtual care will occur post-pandemic, the evolution of how patients and physicians have become more accepting of virtual ...
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On April 19, the AUA joined 26 other physician organizations in expressing support for the Eliminating the Provider Relief Fund Tax Penalties Act (H.R. 2079). This legislation would ensure that all Provider Relief Fund assistance is not taxable, while maintaining that expenses tied to this assistance are tax-deductible. Due to the many challenges and changes put in place during the COVID-19 pandemic, physicians have faced financial uncertainty, and this legislation would provide some relief to many practices across the country. It is also important to note that urologist Representative Neal Dunn, MD (R-FL-02) is championing the bill. The letter is attached. ...
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On April 22, the AUA joined the American College of Surgeons and other member-organizations of the Surgical Coalition in signing a support letter calling for dedicated funding of $100 million for neglected surgical conditions through report language in the Fiscal Year 2022 State and Foreign Operations Appropriations Act. By directing $100 million through the U.S. Agency for International Development, our country can lead the effort to transform health systems in low- and middle-income countries (LMICs), which has the potential to save 17 million lives per year and avert $12.3 trillion in lost GDP in LMICs over the next 15 years. The letter is attached. 04_23 ...
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On April 19, the AUA met with staff in the offices of Representatives Mondaire Jones (D-NY-17) and Tracey Mann (R-KS-01). Rep. Jones is a member of the House Education & Labor Committee, yet much of the conversation was focused on access to telehealth services and health disparities. The congressman is very concerned about disparities and ensuring healthcare access to all Americans. During these conversations, the AUA was able to highlight its work around the Veteran’s Prostate Cancer Treatment and Research Act (H.R. 6092 during the last Congress), a bill that would establish a viable clinical pathway for prostate cancer within the Department of Veterans ...
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On April 21, Legislative Affairs Committee Chair Dr. Robert Bass and Urology Telehealth Task Force Chair Dr. Aaron Spitz participated in a virtual meeting with House Energy & Commerce Committee’s Subcommittee on Health member Representative Kim Schrier, MD (D-WA-08). During the Alliance of Specialty Medicine-hosted meeting, the AUA discussed the expanded use of telemedicine and the need for payment parity for audio-only visits. Dr. Schrier, who was a practicing pediatrician before coming to Congress, acknowledged the wide range of services physicians provide through audio-only visits as well as the lack of access to broadband services for many elderly and ...
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Insurance Updates:  April 21, 2021 Each week, the AUA publishes weekly updates on the latest insurance issues pertaining to urology. This week’s update includes the release of COVID-19 and telehealth/telemedicine specific newsletters and policy updates. Blue Cross Blue Shield (BCBS) Arkansas reviewed its Electrical Stimulation, PTNS for the Treatment of Voiding Dysfunction and Low-dose Rate Brachytherapy for Prostate Cancer Policies. Additionally, BCBS Alabama reviewed its Nerve Graft with Radical Prostatectomy Policy. COVID-19 Updates: BCBS Western NY BCBS Wester NY published its Provider Information Regarding COVID 19 (Coronavirus) provider ...
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In February, the AUA responded to a Request for Information from the National Cancer Institute (NCI) on lowering percent efforts from 75 percent to 50 percent within the Mentored Clinical Scientist Research Career Development Awards (K08). The K08 provides support and "protected time" to postdoctoral and non-tenured junior faculty level clinician-scientists who are interested in intensive, mentored research career development experience in basic, translational, and/or patient-oriented cancer-focused-research. Currently, many applicants do not attempt to apply for these grants because their institutions will not allow them to spend 75 percent of ...
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Nurse Practitioners Seek Independent Practice in Arkansas; Maine Introduces Out-of-Network Provider Bill; Maryland and West Virginia Enact Audio-Only Telehealth Law – The AUA continues to support the full expansion of telehealth services post the current public health emergency, including adoption of audio-only visits. Join the Discussion at Urology Place ; Massachusetts, Missouri, Nevada, and Pennsylvania Seek to Establish Step-Therapy Protocols – the AUA has also met with CMS to address various regulatory barriers to care, including step-therapy; New Mexico Enacts Medical Licensure Law; Oklahoma Seeks to Add ‘General Surgery’ to the List of Professions ...
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This week, the AUA and One Voice Against Cancer (OVAC) met and discussed a new proposal: Advanced Research Projects Agency for Health (ARPA-H). ARPA-H is modeled on the Defense Advanced Research Projects Agency (DARPA), and will coordinate with private industry to develop innovative health products and technologies.   The U.S. healthcare system largely relies on the private sector to leverage national investments in basic research and develop commercially available treatments and cures. As a result, diseases for which investments are risky or downstream profit potential is low, are often ignored. ARPA-H would step in where private companies do not addressing ...
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On April 14, the AUA, along with Dr. Jeffery Jones, chair of the AUA’s VA Health Workgroup, participated in ZERO – the End of Prostate Cancer’s workgroup meeting made up of various prostate cancer stakeholders including Prostate Cancer Foundation. The AUA, which is an active member of this workgroup, discussed the Veteran’s Prostate Cancer Treatment and Research Act. Collaborating for veterans’ health and urologic diseases is vital – especially as the AUA looks to garner widespread support for the legislation and to ultimately have it reintroduced during the 117th Congress.
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On April 15, the AUA met with Representative Blake Moore (R-UT-01), who sits on the House Armed Services Committee. The conversation largely focused on access to telehealth services and the Protecting Access to Post-COVID–19 Telehealth Act (H.R. 366). The AUA supports the full expansion of telehealth services (including the adoption of audio-only visits) – particularly after the public health emergency expires. The AUA also highlighted its work around the Veteran’s Prostate Cancer Treatment and Research Act (H.R. 6092 during the last Congress), which would establish a viable clinical pathway for prostate cancer within the Department of Veterans Affairs (VA). ...
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On April 14, the NCI officially changed their rule to allow K08 applicants to apply for awards at 50% effort. The AUA received the follow response from NCI Center for Cancer Training Director Oliver Bogler: “I particularly appreciate that you gathered input from across your organization and included it in your reply…. Your response informed the decision to make the changes outlined in the recently published NOT-CA-21-054. NCI will now allow surgeon-scientist applicants to reduce the percent effort required for conducting research career development on a K08 award below 75% (nine person-months), but no lower than 50% (six person-month).”   This has been ...
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