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    Election's over: The real campaign starts now

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    This article is part of an ongoing series from the American Association of Clinical Urologists (AACU), based on a partnership between the AACU and Urology Times. Articles are designed to provide updates on legislative processes and issues affecting urologists. We welcome your comments and suggestions about topics for future articles. Contact the AACU government affairs office at 847-517-1050 or [email protected] for more information.

    The November election is over, but the real campaign has just begun. For urologists, that means urgent action on efforts to reverse the payment cuts mandated by the sustainable growth rate (SGR) formula and the fiscal cliff, to name two immediate priorities. The good news: While your involvement is essential, it’s not difficult and will not take a lot of your time. Help is available.

    SGR-mandated cuts

    There is little time for urologists to celebrate or dwell in 2012 national, state, and local election results. Inspired and forward-thinking consideration of how public policies implemented by the divided federal government will shape the practice of medicine over the next 2 years must, temporarily, be left to experts, pundits, and intellectuals.

    In a matter of days, not months or years, Congress and President Obama will determine whether the burgeoning Medicare population maintains access to patient-centered care. Without swift action to reverse the pending 27+% cut to physician services mandated by the SGR formula, practitioners and practices will have no choice but to limit the number of patients they care for at below-cost terms. Patients understand the impossible position physicians have faced and therefore joined in the push for long-term reform many years ago.

    Urologists need not be reminded that clouds of uncertainty have hung over physicians’ heads for nearly 10 years. Temporary "doc fixes" began in 2003, stabilizing reimbursement for periods ranging from a few years to just 30 days. Throughout 2012, Congress solicited and received proposals to replace the SGR from the AACU, former CMS administrators, and their own members. Time may be too short to expect anything more than yet another temporary stabilization measure, unless a permanent solution is included in "must-pass" lame-duck legislation related to taxes, annual deficits, and the national debt.

    Fiscal cliff-mandated cuts

    As if SGR-prescribed reductions to Medicare payments are not enough to inspire the immediate mobilization of physicians, practitioners, and patient allies, ongoing negotiations to avoid the so-called "fiscal cliff" require the medical community’s advocacy, as well. A "mere" 2% cut to provider payments that is already on the table would be very attractive to officials who could (hopefully) point to reversal of the 27% reduction. Disappointingly, two of organized urology’s priorities consistently turn up on budget hawks’ short list: further cuts to federal support of graduate medical education and more stringent prior authorization requirements for diagnostic imaging and radiation therapy services.

    Time to take action

    These are not the only issues urologists must confront at this point late in 2012, but they are the most immediate, pressing, and impactful for your practice, patients, and profession. Fight back any sense of powerlessness. You need not be burdened or overwhelmed by the tasks at hand. Organizations such as the AACU facilitate your engagement on these issues, whether you are willing to go "all in" or can spare just a few minutes. Call on us to schedule and prepare you for meetings with elected officials, or visit the AACU Action Center to quickly comment with a pre-written message. Whichever route you may take, it is imperative that urologists’ voices are heard.

    We encourage you to post your comments about this topic in the "Post a Comment" box below.