October 2022 AUA Public Policy Council Update For MAS

From the Chair
MAAUA Chair 2020

I am pleased to share updates from the AUA Public Policy Council that may benefit your Section members. Our updates include information on advocacy to Medicare payment cuts and AUAPAC giving activities.

Mark Your Calendars!

Registration for the 6th Annual Urology Advocacy Summit opens on November 1. The 2023 AUA Summit will be February 27 – March 1, 2023 at the Capital Hilton in Washington, DC. We look forward to seeing all of you next spring to advocate for the specialty of urology and urologic patients. Register at www.AUASummit.org this November!

Share With Your Trainees: Policy & Advocacy Resident Work Group Soliciting New Members

The AUA’s Policy & Advocacy Resident Work Group is soliciting applications for 2023 work group membership! Medical students, residents, and fellows are eligible to apply for the four remaining spots on the work group.

The Policy & Advocacy Resident Work Group aims to educate trainees on the inner workings of federal and state advocacy by presenting a behind-the-scenes look at the AUA’s policy and advocacy work.

The group is comprised of a mix of medical students, residents and fellows reports to the AUA’s Legislative Affairs Committee and meets quarterly to strategize trainee engagement in urologic advocacy. Historically, the group has also planned educational activities about urologic policy and advocacy and developed resources for trainees. In 2022, this included meeting with the AUA’s registered lobbyists and attending the 5th Annual Urology Advocacy Summit in Washington, DC.

To apply to the work group, please email a brief statement of interest and your CV to Juliana Nicolini at jnicolini@AUAnet.org by October 31, 2022. Applicants will be notified of the decision by December 9, 2022.

If you have any questions or concerns about the Policy & Advocacy Work Group, please do not hesitate to contact Juliana Nicolini via email.

AUA Fiercely Advocates to Mitigate Medicare Physician Fee Schedule Cuts

Every year the AUA analyzes the Medicare Physician Fee Schedule (MPFS) Proposed Rule for the upcoming calendar year and acts swiftly to provide comments to the Centers for Medicare & Medicaid Services (CMS) in an effort to protect reimbursement for urology. In addition, the AUA collaborates with coalitions and meets with Members of Congress and their staff to explore legislative solutions to the Medicare reimbursement system.

In September, the AUA joined with the Surgical Care Coalition, the Alliance of Specialty Medicine, and over 100 provider organizations to send letters to Representatives Ami Bera, MD, (D-CA-07) and Larry Bucshon, MD, (R-IN-08), commending them for introducing the Supporting Medicare Providers Act (H.R. 8800). The legislation would mitigate pending Medicare physician payment cuts by providing a 4.42% positive adjustment to the Medicare Physician Fee Schedule (MPFS) conversion factor for calendar year 2023.

On September 22, the AUA formally endorsed the Supporting Medicare Providers Act (H.R. 8800), led by Representatives Ami Bera, MD, (D-CA-07) and Larry Bucshon, MD (R-IN-08). The letter also calls on Congress to consider legislative and administrative changes to the MPFS to ensure stability, promote and reward value-based care, advance health equity and reduce disparities.

The AUA also participated in a Surgical Coalition meeting with staff in the office of Senator Debbie Stabenow (D-MI). Sen. Stabenow is the Chair of the Senate Finance Subcommittee on Health, which oversees the financing of the Medicare program. The discussion focused on Medicare payment cuts and subsequent structural reform and Sen. Stabenow’s staff expressed interest in introducing a Senate version of the Supporting Medicare Providers Act (H.R. 8800). However, Sen. Stabenow’s staff requested assistance from the coalition in finding a Republican lead on the Senate Finance Committee. The AUA will continue to partner with the Surgical Coalition to promote this important bill in both legislative chambers.

Promoting practice sustainability remains a top legislative and regulatory priority for the AUA. As a reminder, the need for permanent Medicare payment reform was one of the main congressional “asks” during the 2022 Annual Urology Advocacy Summit and is shaping up to be another featured session at the 2023 AUA Summit. The AUA is committed to working independently and with other like-minded physician groups to reduce the impact of payment cuts on the practice of urology and patient access.

For a copy of any of the letters mentioned, please contact the AUA’s Vice President of Legislative & Political Affairs Brad Stine at BStine@AUAnet.org or our Director of Policy & Advocacy Ray Wezik at RWezik@AUAnet.org.

VA Prostate Cancer Legislation Likely Considered During Lame Duck Session

On September 28, the AUA met with staff in the office of Senator Jerry Moran (R-KS) to discuss progress on the Veterans’ Prostate Cancer Treatment and Research Act (S. 2720/H.R. 4880). H.R. 4880/S.2720 would establish a viable clinical pathway for prostate cancer within the Department of Veterans Affairs for those people who selflessly served this nation in uniform. The meeting was to ensure the legislation is on track for consideration this session. During the discussion, Sen. Moran’s staff explained that the bill is on track for inclusion in an end-of-year Veterans’ Affairs omnibus legislative package, which will be considered during the lame duck session following the mid-term elections. The AUA will continue working with committee staff during this legislative session to ensure the bill is enacted prior to the 117^th Congress adjourning.

ICYMI: Updates from the AUA Policy & Advocacy Brief blog

AUA Urges Senate to Extend Telehealth Flexibilities

On September 13, the AUA signed onto a letter urging the Senate to pass a two-year extension for telehealth flexibilities enacted during the COVID-19 pandemic. The two-year extension will include provisions to waive provider and patient limitations, remove in-person requirements for telemental health, ensure continued access to clinically appropriate controlled substances, and increase overall telehealth services in the commercial market.

Virtual health care is a fundamental part of the U.S. healthcare system and helps to improve access to high quality care. The AUA continues to support telehealth efforts to ensure access to quality care. A copy of the letter is attached.

AUAPAC Supports Key Legislators to Advance Urologic Advocacy

In September, AUAPAC supported 12 Members of Congress who sit on key committees of jurisdiction or have demonstrated a commitment to advance health policy. The House Energy & Commerce Health Subcommittee is one of two committees with jurisdiction on various important measures, including prior authorization and physician workforce issues. The House Ways & Means Health Subcommittee has jurisdiction on all taxation and other revenue-raising measures, including the Medicare program. The Senate Health, Education, Labor, & Pensions Committee is one of two committees in the Senate with primary jurisdiction on health policy measures.

Read more about AUAPAC’s participation in these candidate’s fundraisers on the Policy & Advocacy Brief and check out www.myAUAPAC.org to learn more about the candidates we give to.

In September and October, AUAPAC supported: Representatives Ann Kuster (D-NH-02), Terri Sewell (D-AL-07), Brad Wenstrup (R-OH-02), Neal Dunn, MD, (R-FL-02), Michael Burgess, MD (R-TX-26), Vern Buchanan (R-FL-16), Cathy McMorris Rodgers (R-WA-05), John Joyce, MD (R-PA-13), Ami Bera, MD (D-CA-07), and Robin Kelly (D-IL-02); and Senators Maggie Hassan (D-NH) and Lisa Murkowski (R-AK).

Prior Authorization Legislation Passes House of Representatives

On September 14, the U.S. House of Representatives passed the Improving Seniors Timely Access to Care Act (H.R. 3173). As a reminder, H.R. 3173 reforms and expedites the prior authorization process within Medicare Advantage, including establishing an electronic prior authorization process and setting guidelines for prior authorization determinations. Reducing regulatory burdens, including prior authorization, consistently appear as a top issue for our members on the AUA’s Federal Legislative Priority Survey.

The House-passed prior authorization measure now moves to the U.S. Senate for further deliberation. Reforming prior authorization will remain an AUA priority, and the AUA will continue to advocate in support of this measure as it moves through Congress.

AUA Emphasizes Need for Specialists in Rural Area in Meetings on SPARC Act

On September 13-16, the AUA met with staff in the offices of Senators Martin Heinrich (D-NM), Bernie Sanders (I-VT) and Tim Cotton (R-AR) to discuss cosponsorship of the Specialty Physicians Advancing Rural Care (SPARC) Act (S. 4330). As a reminder, S, 4330 would establish a loan forgiveness program designed for specialty physicians who practice in a rural area for six years.

Sen. Heinrich’s staff were responsive to a program that operates parallel to the National Health Services Corps (NHSC) and focuses on providing specialty care in rural areas of America, especially New Mexico. They also felt the SPARC Act establishes a program that not only increases access to specialists but also helps bolster the idea of localized medicine.

Similarly, Sen. Sanders’ staff expressed a general concern about the impending physician workforce shortage, specifically in rural areas with limited access to any medical services. They were also empathetic to the level of student loan debt specialists have and understand that it contributes to the disparity in the number of physicians who practice in rural America.

As for Sen. Cotton’s staff, they acknowledged that specialty physicians’ exclusion from the NHSC needs a remedy and they see the SPARC Act as a viable solution. They also understood that the program would help strengthen care in rural areas without access to specialists. However, they do have concerns about the viability of the legislation from an appropriations perspective, given Congress’ current appetite for loan forgiveness programs.

You can help advocate for the SPARC Act by contacting your U.S. Senators to ask them to cosponsor this legislation. Take Action Now!

AUA Prostate Cancer Impact Alliance Hosts Impact Series: Men Who Have Sex with Men Webinar

The AUA/Urology Care Foundation’s Prostate Cancer Impact Alliance hosted the Impact Series: Men Who Have Sex with Men Webinar. The purpose of this webinar was to address the needs of men who have sex with men who have prostate cancer as they undergo treatment from their urologists and other healthcare providers. This webinar also aimed to make patient advocacy groups and physicians more aware of the challenges and barriers that men who have sex with men face in fighting prostate cancer.

The esteemed panel included Hugh McBride; Lee Newell and Rich Radocchia, LCSW as patient speakers and AUA members LaMont J. Barlow, MD; Tomas L. Griebling, MD and Jordan Bilbrew, MD. A special thank you to Darryl Mittendorf, LCSW, of Malecare for moderating the webinar.

Access a recording of the webinar here: https://www.youtube.com/watch?v=lU-9JmL8pt4

Below are insurance updates from national insurance carriers. If you have questions about insurer issues, contact Bhavika Patel at bpatel@AUAnet.org.

Aetna

Aetna reviewed its Erectile Dysfunction (Commercial) Policy with the following changes:

Added:

Experimental and investigational treatment for erectile dysfunction, platelet-rich plasma injection

Criteria note for semi-rigid or inflatable penile prostheses regarding exceptions to normal prolactin, thyroid hormone, and serum testosterone levels

CPT code 0232T

Updated:

Criteria for Xiaflex for Peyronie’s disease regarding administration by an experienced healthcare provider

ICD-10 coding

Dosage and administration