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Blog Entry
Please Take the Global Surgery Payment Survey Today!

Urologic community data needed to combat the Centers for Medicare & Medicaid Services’ latest regulatory burden to be placed on surgeons. On July 15, 2016, the Centers for Medicare & Medicaid Services (CMS) announced a unilateral decision to implement a new sweeping mandate to...


Blog Entry
United Healthcare and Anthem Blue Cross Prior Authorization Updates

Both United Healthcare (UHC) and Anthem Blue Cross have announced changes to certain prior authorization requirements UHC Updates UHC now requires commercial to use eviCore national services to obtain prior authorization for proton beam therapy. Providers in the UHC Community Plan...


Blog Entry
Survey Shows Docs May Not Be Aware of MACRA

A recent survey by Deloitte indicated that nearly half of the physicians in the United States are unfamiliar with the Medicare Access and CHIP Reauthorization Act (MACRA), which is expected to bring major reforms to care delivery and payment starting in 2017. As you may recall, MACRA is the...


Blog Entry
2016 AUA PQRS Toolkit Now Available

Participating in the Centers for Medicare & Medicaid Services’ (CMS) Physician Quality Reporting System (PQRS) has become more important than ever. Not only will providers who see Medicare Part B patients be penalized for not reporting, but their PQRS score will be used to calculate...


Blog Entry
AUA Prior Authorization Tools Now Available

Ask any physician, in nearly any specialty, about prior authorization and the message will be clear: obtaining necessary pre-approvals for physician services is a time-consuming problem. And, as a growing number of private insurers are requiring prior authorizations, it’s only going to get worse...


Blog Entry
New Oncology Care Model for Cancer Treatment Participants Announced

On June 29, 2016, after much anticipation, , the Department of Health and Human Services (HHS) Center for Medicare & Medicaid Innovation (CMMI) announced the physician group practices and insurers selected to participate in the new Oncology Care Model (OCM) . HHS first announced the...


Blog Entry
CMS Releases Proposed 2017 Medicare Physician Fee Schedule

On July 7, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2017 Medicare Physician Fee Schedule proposed rule. This rule contains a number of important changes relevant to urology services. In the rule, CMS notes that most of the proposed policy changes are...


Blog Entry
CMS Rejects Refinement Panel Recommendation for Laparoscopic Radical Prostatectomy

Agency Will Consider New Data for Valuation of 55866 In a proposed rule released late today, the Centers for Medicare & Medicaid Services (CMS) announced its decision to maintain the interim final work relative value units (RVU) of 21.36 for laparoscopic radical prostatectomy (CPT...


Blog Entry
Medicare Physician Fee Schedule Update

The AUA is monitoring the upcoming release of the Medicare Physician Fee Schedule (MPFS) proposed rule. While currently still in review at this time, the Centers for Medicare & Medicaid Services (CMS) usually releases the MPFS proposed rule, along with the Outpatient/Ambulatory Surgical...


Blog Entry
MACRA Proposed Implementing Regulations: AUA, Alliance of Specialty Medicine Comment Letters

On June 27, the AUA submitted a formal comment letter to the Centers for Medicare & Medicaid Services (CMS) on the proposed rule on Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive under the Physician Fee Schedule, and Criteria for Physician...