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    AUA legislative priorities: One down, nine to go

    SGR repeal, access to PSA testing, USPSTF reform head list

    Bob Gatty

    WashingtonLast Dec. 31, President Obama signed the 2014 National Defense Authorization Act, and it was a major victory for urology.

    “Advocacy does work,” said James C. Ulchaker, MD, chairman of the AUA Legislative Affairs Committee.

    The reason Dr. Ulchaker was so pleased with the president signing legislation to fund America’s defense activities is that the massive bill included the AUA’s proposal to establish a task force on urotrauma suffered by America’s troops, especially those in combat.

    When the urotrauma language was included in the defense bill approved by the House of Representatives Dec. 12, urologist Mark Edney, MD, a veteran of Operation Iraqi Freedom and the AUA’s lead advocate on the issue, said the action was “a case study in what well-funded, AUA-led, coalition-based advocacy can be.”

    The provision requires the Department of Defense to work with the Department of Veterans Affairs to develop and implement a comprehensive policy on improvements to the care, management, and transition of recovering members of the Armed Forces with urotrauma. Rep. Brett Guthrie (R-KY) and Sens. Ben Cardin (D-MD) and Roy Blunt (R-MO) championed the measure in Congress.

    SGR repeal tops priority list

    Now, the AUA has turned its attention to nine new legislative and regulatory priorities for 2014, based on the results of an online survey of members. Topping that list is the need to develop “viable strategies” for sustainable growth rate (SGR) repeal and promotion of value in health care.

    In a new position statement, the AUA said urologists are pleased that each of the health committees’ proposals to address the SGR proposes repeal of the “flawed formula,” and said its elimination “is essential to ensuring a stable payment system that provides Medicare beneficiaries timely access to care.”

    However, the AUA stressed that these key principles must be included:

    • ensure that all physicians receive equitable reimbursement
    • follow repeal by a minimum 5-year period of payment stability
    • maintain a viable fee-for-service option
    • incentivize meaningful, physician-led quality improvement, rather than penalize based on arbitrary indicators of performance
    • limit unnecessary regulatory requirements
    • include legal protections for physicians who satisfy quality improvement program requirements.

    “We are a leader in terms of quality and we’ve got to make sure that reform supports good behavior, but it shouldn’t be punitive,” Dr. Ulchaker said. “Rather, it should be supportive and give credit for good behavior by physicians.”

    There is also substantial concern how the cost of reform will be covered.

    “You can’t just be taking from specialty medicine and giving it to primary care,” he stressed. “That would just exacerbate greater shortages in the future.”

    Bob Gatty
    Bob Gatty, a former congressional aide, covers news from Washington for Urology Times.

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