Blogs

AUA, LUGPA and AACU Meet with CMS on ESWL Payment in ASC

By Policy and Advocacy Brief
On December 5, 2019, representatives from the AUA, LUGPA and AACU met with the Centers for Medicare & Medicaid Services (CMS) Division of Outpatient Care and Hospital & Ambulatory Policy Group. This was the first time all three organizations met with CMS as a unified voice, in this case to discuss the payment disparity for CPT code 50590 Lithotripsy, extracorporeal shock wave also known as ESWL. The meeting came about after many years of changes in outpatient payment assignments in the Ambulatory Payment Classification (APC) for CPT code 50590. The recent change in assignment of ESWL from APC 5375 to 5374 caused a decrease in payment in the outpatient ...
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AUA Advocacy Snapshot: Week of December 2, 2019

By Policy and Advocacy Brief
This week’s update includes news about our comment letter to the House Ways & Means Committee on priority topics that affect health status and outcomes in underserved communities as well as research and state advocacy updates. Urologic Workforce: AUA Sends Comment Letter to House Ways & Means Committee On November 29, the AUA submitted a comment letter in response to the House Ways & Means Committee’s request for information soliciting input on priority topics that affect health status and outcomes in underserved communities. The information collected will be used to inform the bipartisan Rural and Underserved Communities Health Task Force ...
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Join Us for the 2020 Annual Urology Advocacy Summit!

By Policy and Advocacy Brief
Every AUA member has a story about how laws and regulations affect their patients and practice. What's yours?  This March, join your urology colleagues from across the country for the 2020 AUA Summit in Washington, DC. This free, three-day conference will educate all facets of the urologic community on policies that affect practice and patient care and will include a day of meetings with federal agencies, legislators and their staff on and around Capitol Hill.  We are pleased to announce that Margaret Brennan, moderator of "Face the Nation" and CBS News' Senior Foreign Affairs Correspondent will deliver the opening keynote address on March 16. ...
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Frequently Asked Questions: USP General Chapter <800> Delayed Implementation and its Impact on Urology Practice

By Policy and Advocacy Brief
Earlier this year, the U.S. Pharmacopoeia (USP) announced that it would be updating three important chapters in its compendium: General Chapters 795 Pharmaceutical Compounding – Nonsterile Preparations ; General Chapter 797  Pharmaceutical Compounding – Sterile Preparations ; and General Chapter 825 Radiopharmaceuticals – Preparation, Compounding, Dispensing, and Repackaging . Chapters 795 and 797 are intended to minimize the risk of patient harm in the areas of nonsterile and sterile compounding. The new chapters were to become official on the same date as USP General Chapter 800 Hazardous Drugs – Handling in Healthcare Settings . ...
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FDA Announces New Supplement Recall

By Policy and Advocacy Brief
The Food and Drug Administration (FDA) announced several supplements promoted for sexual enhancement have been found to contain undeclared active ingredients.  The presence of undeclared active ingredients renders the products unapproved drugs for which safety and efficacy has not been established and, therefore, subject to recall.  The concerned products and the undeclared active ingredient include: Power Khan , desmethyl thiosildenafil, thioaildenafil, and aildenafil Silver Bullet 10 Male Enhancement Capsules , sildenafil Sildenafil is an FDA approved drugs for the treatment of male erectile dysfunction.  Desmethyl thiosildenafil, thioaildenafil, ...
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AUA Top 10 2020 MIPS Takeaways

By Policy and Advocacy Brief
Have questions about the 2020 MIPS program?  The AUA makes it easy for you by highlighting the top 10 things you need to know in this new brochure. Find out more by visiting the AUA’s 2019 MIPS Toolkit .   Look for more educational resources in the months to come, but if you have questions, contact the AUA at Quality@AUAnet.org or 410-689-3
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Insurance Updates: Week of December 2, 2019

By Policy and Advocacy Brief
Each week, the AUA publishes weekly updates on the latest insurance issues pertaining to urology. This week’s update includes Quartz Health Plan’s Prostatic Urethral Lift update, a new policy from Health Now, and updates to Prostate treatment policies from Capital Blue Cross Blue Shield (BCBS) and BCBS of North Dakota. BCBS of Florida has updated the Temporary Prostatic Stent and Prostatic Urethral Lift medical policy, Providence Health Plan has revised the Prostate Water Vapor Thermotherapy for Benign Prostatic Hyperplasia policy and BCBS Federal Employee Plan, Humana and Health Now New York each have new policies for the FDA-approved drug Nubeqa. Quartz ...
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AUA Advocacy Snapshot: Week of November 25, 2019

By Policy and Advocacy Brief
This week’s update includes information on our meeting with the Senate Finance Committee on payment policy, as well as our state advocacy news from New Jersey and South Carolina and our call with the Rocky Mountain Urological Society Board. MACRA Implementation: AUA Meets with Senate Finance Committee On November 21, the AUA and the Alliance of Specialty Medicine met with Sen. Tim Scott (R-SC) and Sen. Bill Cassidy (R-LA) to discuss the current status of Medicare Access and CHIP Reauthorization Act (MACRA) implementation. The Alliance urged Congress, via the committee, to recognize that the Medicare fee-for-service (FFS) remains the most appropriate reimbursement ...
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Insurance Updates: Week of 25 November 25, 2019

By Policy and Advocacy Brief
Each week, the AUA publishes weekly updates on the latest insurance issues pertaining to urology. This week’s update includes Boston Medical Center’s update for Posterior Tibial Nerve Stimulation, Emblem Health’s Cryosurgical Ablation for Prostate Cancer, and United Healthcare’s Outpatient Surgical Procedure medical policy. Also included is Horizon Blue Cross Blue Shield New Jersey’s revision for Radiation Therapy for Prostate Cancer and GnRH Agonists and Antagonists, Blue Cross Blue Shield Arizona Prior Authorization requirements for Nubeqa, Blue Cross Blue Shield Kansas City Missouri has revised the Prostatic Urethral Lift, and Blue Cross Blue Shield North ...
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AMA House of Delegates Interim Meeting Recap: Day 4

By Policy and Advocacy Brief
The American Urological Association’s Delegates – Dr. Terrance Grimm and Dr. Hans Arora, Alternate Delegate Dr. Jason Jameson, Resident and Fellow Delegate Dr.Ruchika Talwar, and Young Physicians Section Delegate Dr. Clint Cary – have joined the AACU, Urology Caucus, and hundreds of physicians at the American Medical Association (AMA) House of Delegates 2019 Interim Meeting to consider resolutions and reports covering clinical practice, payment, medical education, and public health topics. View our previous updates: Report from Days 1 and 2 Report from Day 3 On November 19, the AUA delegates spent the day in the general session where they participated ...
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FDA Approves New Antibacterial Drug to Treat Complicated Urinary Tract Infections

By Policy and Advocacy Brief
The U.S. Food and Drug Administration (FDA) has approved Fetroja (cefiderocol), an antibacterial drug for treatment of patients 18 years of age or older with complicated urinary tract infections (cUTI), including kidney infections caused by susceptible Gram-negative microorganisms, who have limited or no alternative treatment options. Labeling for Fetroja includes a warning regarding the higher all-cause mortality rate observed in Fetroja-treated patients compared to those treated with other antibiotics. Common adverse reactions include diarrhea, constipation, nausea, vomiting, elevations in liver tests, rash, infusion site reactions, yeast infection, cough, ...
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Medicare Publishes Additional Resources to Bill Correctly for Medicare Telehealth Services

By Policy and Advocacy Brief
IThe AUA recently published an article on coding for telemedicine services . In an effort to keep members apprised of any additional information on proper coding of telehealth services, the following article was published in the November 7, 2019, issue of MLN Connects , official CMS news from the Medicare Learning Network. In a recent  report , the Office of Inspector General (OIG) determined that the Centers for Medicare & Medicaid Services (CMS) improperly paid practitioners for some telehealth claims associated with services that did not meet Medicare requirements. CMS released the  Medicare Telehealth Services  Video to help you bill correctly. Additional ...
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AMA House of Delegates Interim Meeting Recap: Day 3

By Policy and Advocacy Brief
The American Urological Association’s Delegates – Dr. Terrance Grimm and Dr. Hans Arora, Alternate Delegate Dr. Jason Jameson, Resident and Fellow Delegate Dr. Ruchika Talwar, and Young Physicians Section Delegate Dr. Clint Cary – have joined the AACU, Urology Caucus, and hundreds of physicians at the American Medical Association (AMA) House of Delegates 2019 Interim Meeting to consider resolutions and reports covering clinical practice, payment, medical education, and public health topics. Read our update from the first two days of the meeting. On November 18, the AUA delegates spent the day in the general session where they participated in spirited debates ...
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AUA Advocacy Snapshot: Week of November 18, 2019

By Policy and Advocacy Brief
This week’s update announces the opening of registration for the 2020 Annual Urology Advocacy Summit and shares our reports from the American Medical Association House of Delegates. 2020 AUA Summit: Registration Now Open! Make plans now to join your colleagues from across the country at the 2020 Annual Urology Advocacy Summit in Washington, DC in March! This free, three-day conference will educate all facets of the urologic community on policies that affect practice and patient care, and will include a day of meetings with federal agencies, legislators and their staff on and around Capitol Hill. Register today! AMA House of Delegates: AUA Physicians ...
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AMA House of Delegates Interim Meeting Recap: Days 1 and 2

By Policy and Advocacy Brief
The American Urological Association’s Delegates – Dr. Terrance Grimm and Hans Arora, Alternate Delegate Dr. Jason Jameson, Resident and Fellow Delegate Dr. Ruchika Talwar, and Young Physicians Section Representative Dr. Clint Cary – have joined hundreds of physicians at the American Medical Association (AMA) House of Delegates 2019 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. (Read updates from Day 3.) On November 16, AUA delegates attended the Surgical Caucus meeting ...
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Insurance Updates: Week of November 18, 2019

By Policy and Advocacy Brief
Each week, the AUA publishes weekly updates on the latest insurance issues pertaining to urology. This week’s update includes Anthem’s updated policy for Botulinum Toxin, CMS’s updated information for the use of new Medicare cards, and Highmark’s revision for the Treatment of Prostate Cancer and Diagnosis and Treatment of Male Sexual Dysfunction. In addition, it includes Humana’s new policy for Prolia (denosuab), Medical Mutual’s new policy for Nubeqa, Dean Health Plan’s revised Stereotactic Body Radiotherapy medical policy, and Blue Cross Blue Shield Michigan’s decision to stop covering the 500 mg dose of Zytiga. Anthem Botulinum Toxin: Anthem has ...
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AUA Advocacy Snapshot: Week of November 11, 2019

By Policy and Advocacy Brief
This week’s update includes information on our second annual Insurance Roundtable, as well as state advocacy updates on surprise billing legislation in Ohio and California.   AUA Insurance Roundtable: Insurers, CMS, Discuss 2021 E/M Codes and More On November 8, 2019, the AUA hosted its second annual Insurance Roundtable. More than 35 individuals —including representatives from Cigna, Anthem Blue Cross, Aetna, Highmark Blue Cross Blue Shield; Medicare Administrative Contractors (MACs) Noridian, Novitas, and NGS; 15 different specialty societies, the Centers for Medicare & Medicaid Services (CMS) Program Integrity area — for a full day of panel discussions ...
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Top Takeaways from the November 8 First Friday Clinician Outreach Meeting

By Policy and Advocacy Brief
The top takeaways from the Centers for Medicare & Medicaid Services (CMS) November Clinician Outreach Meeting focused on Open Payments Program updates, the Medicare Physician Fee Schedule (PFS) final rule, and the Quality Payment Program (QPP). Open Payments Program      As a reminder, providers have until December 31, 2019 to have their records reviewed before making a final submission. More information is available here. Registration is required for anyone requesting a data review. Please email openpayments@cms.hhs.gov if you need assistance with any part of this process. Physician Fee Schedule General Updates CMS has finalized the Evaluation ...
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Insurance Updates: Week of November 11, 2019

By Policy and Advocacy Brief
Each week, the AUA publishes weekly updates on the latest insurance issues pertaining to urology. This week’s update includes Anthem’s new policy for male circumcision, CGS Medicare’s new billing and coding article for Urodynamics, Cigna’s policy for male sexual dysfunction, Harvard Pilgrim’s use of the NDC codes, and Noridian’s Target Probe and Educate results for Urology Supplies are in.  Anthem Male Circumcision : Anthem has a new medical policy for Male Circumcision. They describe this as a surgical procedure to remove the foreskin of the penis. The new policy addresses circumcision in males older than 4 weeks in corrected age (corrected age is ...
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AUA Advocacy Snapshot: Week of November 4, 2019

By Policy and Advocacy Brief
This week’s update includes information on the Centers for Medicare & Medicaid Services (CMS) final rule for the 2020 Medicare Physician Fee Schedule and the Quality Payment Program, the AUA’s November Bladder Health Month campaign, and our ongoing congressional outreach efforts in introducing urology to freshman lawmakers. CMS Rulemaking: Final 2020 Rules for the Medicare Physician Fee Schedule and the Quality Payment Program Released On November 1, 2019, CMS released the CY 2020 Medicare Physician Fee Schedule (MPFS) and Quality Payment Program final rule, as well as the 2020 Outpatient/Ambulatory Surgical Center Payment System final rule. The ...
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