Richard S. Pelman, MD
An update on the state of urology and the 2014 legislative and clinical priorities for the profession was offered by three leaders in the field during a panel discussion at the Urology Joint Advocacy Conference. Richard S. Pelman, MD, president of the American Association of Clinical Urologists (AACU), David Penson, MD, MPH, Health Policy Chair for the American Urological Association (AUA), and Juan Reyna, MD, president of LUGPA, also provided brief summaries of the recent accomplishments of their organizations.
Because urologists are faced with an enormous burden of existing and pending bureaucratic responsibilities—from HIPAA, electronic health records, and ICD-10 coding to health insurance preauthorization phone calls and pharmacy authorization letters—Pelman commended JAC attendees for being proactive about those issues by participating in the meeting.
“We’re not quite ready to be like Howard Beale [from the motion picture Network] throwing his head out the window and yelling ‘I'm mad as hell, and I'm not going to take this anymore!’ but we can band together to bring a voice for our patients, for our concerns, for the way we practice, and for our ability to take back medicine," he said.
In a call to action, he highlighted the kind of community efforts that start in one state and slowly spread to another. He emphasized the success associated with the issue of freedom of licensure. This goal ensures for fair and open contractual relationships between third-party payers and healthcare providers and prohibits tying healthcare provider licensure to participation in a third-party payer program. “We just recently protected ourselves in Washington State. We’ve already seen this in Alabama, Georgia, and Virginia,” he said.
Pelman also touched on the question of whether the Medicare Payment Advisory Commission (MedPAC) will advise Medicare to reimburse for prostate-specific antigen (PSA) screening in light of the recommendation against the practice 2 years ago by the US Preventive Services Task Force (USPSTF). There have been discussions indicating that this screening might not be reimbursed for Medicare patients, and the AACU has launched an educational campaign to reach primary-care physicians, patients, and the media about PSA testing and the importance it plays in treating prostate cancer. AACU has been critical about the way the USPSTF analyzed the data and the organization’s recommendation.
The AACU also plans to provide medical practices with a specialized log that will help them track the amount of uncompensated time their staff members spend on bureaucratic procedures, Pelman said, and is working on medical liability reform by moving to ensure that conflicts are resolved only by experts in the specialties at the heart of each case.
He urged attendees to fight for their profession by “developing data” on issues such as whether quality measures set as benchmarks for urologists are appropriate. In addition to joining the AACU and asking others to do the same, urologists can help by forming and joining state urology societies that can serve as resources for government as it makes decisions that affect the field, Pelman said.
“Those at the local levels who are active are sought out,” he said. “We can provide input, and we can win.”
Penson discussed the allocation of the AUA’s lobbying resources and how the group plans to support the policy needs of its members.
David F. Penson, MD
“AUA has [had] a single Health Policy Division for some time, but we now have numerous objectives, so much so that the infrastructure has gotten extremely large,” said Penson.
As a result, the Health Policy Division has been broken out into two groups—the Public Policy and Practice Support (PPPS) group and the Science and Quality group. Penson explained that legislative affairs, coding and reimbursement, and practice management would fall under the PPPS group umbrella, with committees such as guidelines, quality improvement in patient safety, and data housed under the Science and Quality group. “It’s going to be one happy family, just with more structure and more resources to promote all the work we are doing,” he told the audience.