Blogs

Insurance Updates:  March 3, 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) Kansas reviewed its Prostatic Urethral Lift Policy. Additionally, BCBS North Carolina updated its Botulinum Toxin Policy. COVID-19 Updates: BCBS Western New York (NY) BCBS Western NY published its Provider Information Regarding COVID 19 (Coronavirus) News & Announcements bulletin announcing: Continued waiver of the cost-share for COVID-19 diagnostic testing ...
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California Introduces Prostate Cancer Screening Without Cost-Sharing Bill – Expanding access to prostate cancer screening is a top AUA state advocacy initiative and the AUA is working with stakeholders to promote this particular measure; Alabama Introduces Resolution to Designate September 2021 as Prostate Cancer Awareness Month; Intersex Bills Introduced in Arkansas, Iowa and Nevada – The AUA continues to advocate medical decision-making on behalf of children remain the responsibility of parents and therefore, should not be legislated; New York and Illinois Considering Controversial Medical Malpractice Measures – Expanding medical liability protections ...
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On February 23, the AUA sent a letter to Dr. Matthews, Executive Director for the Medicare Payment Advisory Commission (MedPAC), with recommendations on telehealth policy following the public health emergency (PHE). In the letter, the AUA suggests retaining current waivers for originating site requirements, retaining audio-only telehealth visits, establishing payment parity for in-person and telehealth visits, and maintaining maximum overall flexibility in the delivery of telehealth services. The letter notes the success of telehealth services and telehealth delivery during the PHE prove telehealth is a workable and viable tool for the future of medicine.   ...
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The AUA is working to procure a $10 million dedicated research program, or line item, for bladder cancer within the Congressionally Directed Medical Research Programs (CDMRP). Last week, the AUA, in collaboration with the Bladder Cancer Advocacy Network, met with the offices of Representative Julia Brownley (D-CA-26), Representative Cheri Bustos (D-IL-17), Representative Gregory F. Murphy (R-NC-3), Representative John Rutherford (R-FL-4), and Representative Neal Dunn (R-FL-2) to discuss the AUA’s Fiscal Year (FY) 2022 research appropriation funding priorities around the creation of a bladder cancer research program within CDMRP. CDMRP is a major funder of scientific ...
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On February 22, the AUA attended a policy webinar hosted by Representative Carolyn Bourdeaux (D-GA-07), a freshman member of Congress who is passionate about healthcare and hopes to serve on either the House Energy & Commerce Committee or House Ways & Means Committee during her congressional tenure. She addressed COVID-19 and subsequent vaccination disparities. Representative Bourdeaux also expressed support for the permanent expansion of the use and reimbursement of telehealth services, which the AUA has been strongly advocating for over the past twelve months. Finally, the congresswoman expressed the need for continued financial support of health care ...
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Insurance Updates:  February 24, 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) Kansas City Missouri reviewed its Erectile Dysfunction, Prostate Biopsies and Urinary Tumor Markers for Bladder Cancer Policies. COVID-19 Updates: CareFirst BCBS CareFirst BCBS published its Coronavirus Resource Center for Healthcare Providers News & Announcements provider bulletin, announcing: It is waiving cost sharing for in-network or out-of-network ...
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State Advocacy Updates Prostate Cancer Bill Introduced in Illinois to Allow for Testing Without a Written Order; Florida Introduces Two Step-Therapy Bills – At the national level, the AUA has met with the Centers for Medicare & Medicaid Services (CMS) to address various regulatory barriers to care such as step-therapy;  Several States Seek to Cap the Cost of Monthly Insulin Supplies; Kentucky and Montana Introduce Intersex Bills;  Rhode Island and Montana Join the Many States with Bills Addressing Pelvic Exam; and Telemedicine Continues to be Refined in the States Allowing for Audio-Only and Reimbursement Parity – The AUA continues to support ...
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On February 18, the AUA joined 23 other physician groups in a meet and greet with Congresswoman Kathleen Rice (D-NY-04). A former prosecutor, Rep. Rice recently has been appointed to the House Energy & Commerce Committee – one of the two House committees with jurisdiction on health policy. Congresswoman Rice is a strong supporter of expanded use of telehealth services, reforming the prior authorization process, halting the Medicare sequester cuts for the duration of the public health emergency and other AUA-supported or -championed legislative issues. The AUA will continue identifying ways to work with Rep. Rice whenever possible.
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The AUA joined more than 30 other organizations in signing on to a letter authored by the American Association for Clinical Chemistry. The letter, addressed to Senator Patty Murray (D-WA), Senator Roy Blunt (R-MO), Representative Rosa DeLauro (D-CT-03), and Representative Tom Cole (R-OK-04), requested an additional $10 million to fund the CDC effort to update and correct existing pediatric reference intervals. Reference intervals are the range of numeric values that would be expected in a healthy patient following a lab test. If a patient’s lab results fall outside of the reference interval, the practitioner may order medical intervention to address the condition. ...
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Last week, the AUA signed on to a letter with One Voice Against Cancer (OVAC), which was then delivered to members of Congress. The letter was in support of 2021 emergency funding to the National Institutes of Health (NIH) as a result of disruptions caused by the COVID-19 pandemic, as well as support for an increase in research funding for Fiscal Year 2022 (FY22). The OVAC letter is in line with AUA advocacy initiatives urging Congress to provide the NIH with at least $15.5 billion in response to the COVID-19 emergency, a funding level of at least $46.1 billion for NIH funding in FY 2022, including $7.6 billion directed toward to the National Cancer Institute, ...
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Insurance Updates:  February 17, 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) North Dakota reviewed its Chemodenervation with Botulinum Toxin and Urological Supplies Policies. Additionally, BCBS North Carolina updated its Gene Expression Profiling and Protein Biomarkers for Prostate Cancer Management Policy. COVID-19 Updates: Aetna Aetna published its COVID 19 Patient Coverage News & Announcements provider bulletin: Announcing for ...
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Alabama Seeks to Abolish Certificate of Need; Many States Introduce Telemedicine Bills Addressing Prescribing, Payment Parity, Origination Site, Utilization Review and Separate Cost-Sharing – The AUA supports the full expansion of telehealth following the current public health emergency and treatment and has met with CMS to urge the adoption of audio-only visits; Florida Wants to Allow Pro Bono Services to Count Toward Continuing Education Requirement; New Jersey Looks to Address Step-Therapy – The AUA has met with CMS to address and oppose various regulatory barriers to care such as step-therapy and has endorsed these  specific state bills;  Tennessee ...
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On February 11, the AUA attended the American Society of Clinical Oncology Genitourinary Cancers Symposium (ASCO GU), where top researchers presented on new, innovative findings in the study, diagnosis and treatment of GU malignancies. Many presentations focused on health disparities in the treatment of genitourinary cancers, including a paper on the use of prostate-specific antigen velocity (PSAV) to predict how well African American men would respond to active surveillance treatment protocols. The paper found African American men were more likely to progress at lower values of PSAV and therefore merit close follow-up if they were on active surveillance. Another ...
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Last week, the AUA participated in a meeting with the Friends of Veterans Affairs Medical Care and Health Research (FOVA), a coalition of more than 90 national academic, medical and scientific societies; voluntary health and patient advocacy groups; and veteran-focused associations; and One Voice Against Cancer (OVAC), a broad coalition of public interest groups representing millions of cancer patients, researchers, providers, survivors and their families. Both of these meetings discussed plans for Fiscal Year 2022 (FY 22) research funding and supplemental research funding for 2021.   The OVAC meeting included research-related federal funding updates ...
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On February 12, the AUA joined the AMA and other national specialty and state medical societies in support of the Medicare Sequester COVID Moratorium Act (H.R. 315) introduced by Representatives Brad Schneider (D-IL-10) and David McKinley (R-WV-01). The bill would delay the Medicare sequester through the duration of the public health emergency, ensuring providers can stay focused on treating and eradicating COVID-19 instead of worrying about their bottom line. Since 2011, Medicare payments have been subject to a 2 percent reduction, known as the Medicare sequester. However, Congress delayed the Medicare sequester through April 1, 2021, as part of the Consolidated ...
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On February 11, the AUA submitted a letter to the National Cancer Institute (NCI) in response to the RFI : Inviting Comments and Suggestions on the Surgeon-Scientist Effort Requirement on K08 Awards from the National Cancer Institute .   The AUA encouraged the NCI to lower the percent effort for K08 awards to 50 percent and provided a rationale for how the reduced effort would positively affect surgeon scientist participation. The AUA believes a 50 percent effort is sufficient for active surgeon-scientists to succeed in their research and career development activities under the K08, The AUA believes if a minimum 75 percent effort requirement ...
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State Advocacy Update Several States Introduce Cost-Sharing for Insulin; Multiple Telemedicine Measure Introduced Addressing Reimbursement Parity, Technology, Patient-Physician Relationship, and Allow Audio-Only Visits – The AUA supports the full expansion of telehealth following the current public health emergency and treatment and has met with CMS to urge the adoption of audio-only visits; California Looks to Address Step-Therapy – The AUA has met with CMS to address and oppose various regulatory barriers to care such as step therapy; Iowa and Kentucky Introduce Intersex Bills – The AUA advocates for medical decision-making for children remaining ...
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The top takeaway from the CMS February Clinician Outreach meeting focused primarily on the updated COVID-19 Vaccination Resource Toolkit . This toolkit includes information to describe: How health care providers can enroll in Medicare to bill for administering COVID-19 vaccines The COVID-19 Vaccine Medicare coding structure The Medicare reimbursement strategy for COVID-19 vaccine administration How health care providers can bill correctly for administering vaccines, including roster and centralized billing.   The AUA will continue to provide updates from these monthly meetings.
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The AUA participated in a virtual meeting to discuss such healthcare priorities for the 117th Congress as additional COVID-19 relief funding, the need to produce more vaccinations in order to achieve herd immunity and the need to lower drug prices for the American people. The meeting was held with Gerry Petrella, Policy Director for Senate Majority Leader Chuck Schumer (D-NY). In addition to the items mentioned above, Petrella addressed Senator Schumer and Senate Minority Leader Mitch McConnell’s (R-KY) recent agreement on the 50-50 organizing resolution. Other agreement details discussed included, if a committee is deadlocked on a nomination or legislation, ...
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Early February, AUA staff attended the annual meeting of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) as Friends of NIDDK. At the meeting, representatives from NIDDK discussed their commitment to combating racial and ethnic disparities, their focus on patient-centered outcomes and their response to the COVID-19 emergency. They spoke of advancements in kidney research including a new technology to move kidney stones through the body using an ultrasound technique, as well as a novel study that demonstrated small-molecule inhibitors can restore telomerase activities in patient stem cells. NIDDK’s most immediate concern was COVID-19’s ...
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