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AUA Public Policy Overview
Lindsey A. Kerr, MD, MA, RYT-300, FPMRS -certified
Director, Pelvic Floor Specialty Center, Eastern Maine Health Systems
SWIU Liaison to AUA Public Policy Council
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Public Policy Council: Christopher Gonzalez, MD, MBA Patient and Research Advocacy oBuilding coalitions of urologists, patients, and researchers.
Government Relations and Advocacy oLegislative Affairs Committee Chair: Jim Ulchaker, MD oStaff of 4 employees/3 registered D.C. lobbyists
Practice Management oPractice Management Committee: Jay Motola, MD oStaff of 6 employees/2 certified professional coders
Regulation and Reimbursement oCoding and Reimbursement Committee: Ron Kaufman, MD oStaff of 5 employees/3 certified professional coders
Who We Are
Public Policy & Practice Support Division
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Patient & Research Advocacy
o Integrates AUA’s advocacy strategy and Urology Care Foundation’s advocacy strategy in conjunction with patient groups and research advocates.
o Builds coalitions to promote research and grow patient advocacy programs to support common and differing priorities
What We Do
Public Policy & Practice Support Division
Header. Arial 48. Patient & Research Advocacy
o Congressional recognition for Bladder Health Awareness Month (November 2016) Resolution o Bladder Health Alliance: Two meetings in AUA Headquarters, online
community (AUA Portal)
o HSS put on their portal - put out information to other organizations, and the media
o Met with Society of Women’s Health Research to strategize on increased funding for urologic research o The passage of the Urotrauma bill was facilitated with SWHR
o Patient Advocacy Hub meeting at the AUA
Recent Accomplishments
Public Policy & Practice Support Division
Government Relations and Advocacy o Challenge legislation that negatively impact urology’s ability to
provide quality patient care
o Coalition building (e.g. ACS, AMA, researchers, SWIU)
What We Do
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Government Relations and Advocacy
o > 330 Hill meetings between AUA members, AUA staff, and Congressional offices - cosponsors
o Launching 2018 Annual Urology Advocacy Summit
o Program Group tentatively includes 15 urological specialties, 8 AUA Sections o March 12-14, 2018
o March 2017: Joint Advocacy Conference o https://www.JAC2017.org
Recent Accomplishments
Public Policy & Practice Support Division
USPSTF o “D” grade to PSA testing
o No urologists on the panel, data review was not objective o Shift in payors willingness to cover PSA o Increase in “PSA” deaths and later stage presentations
o Three nominees now to join the scientific evidence review panel
ACA (Pending) o Medical malpractice o Repeal of the Independent Physician Advisory Board o Impact on critical access hospitals o Ability of urologic patients to seek affordable care
Recent Accomplishments
Fighting Insurance Company Mergers o “Anthem and Cigna, Aetna and Humana o Lessening severity of MIPS/MACRA Ruling
Work With the AMA “House of Medicine” o Representation based on proportion of Urologists as AMA
members o 14 Physicians in the US Legislature o Residents /Fellows part of DACA o ? Condemnation of Female Genital Mutilation – tabled for
further study o Transparency of Hormone compounding
Recent Accomplishments
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Practice Management
o Assists urology practices in operating their practice o Provides an Online community for members o Provide education on clinical, business and operational topics
What They Do
Public Policy & Practice Support Division
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Regulation & Reimbursement o Works with Insurers on Coverage Issues o Reviews Key Regulatory Issues Affecting Urology o Develops/Revises CPT codes to report urologic procedures
and services o Represents urology before the AMA /Specialty Society Relative
Value Scale Update Committee to present survey data on a new and current CPT codes
What They Do
Public Policy & Practice Support Division
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Regulation & Reimbursement o Nov 2, CMS Victory – RVU for RRRP increased the wRVU
from 21.36 to 26.80, work our of AMA specialty society RUC and LUGPA ,$ 2.84 mil
o Loss for cystoscopy wRVU from 2.23 to 1.53 represents a loss of $22,666,724
o RUC Survey Process: AUA Health Policy is coming to us o Health Policy is always looks for experts: EMG, Bladder
instillations –carcinogenic and non-carcinogenic o Expertise in other areas – Urolift, percutaneous implantation
of Neurostimulator, , billing of TR ultrasound, Urostym Pelvic Floor Rehabilitation System
Accomplishments/To Do List
Public Policy & Practice Support Division
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Patient and Research Advocacy oBring in perspective of entire urologic community.
Government Relations and Advocacy oProvide expert analysis of healthcare policy oTrain physician members to be advocates
Practice Management oGather information on specific urology issues for practices oProvide education and training to practices
Regulation & Reimbursement oLook at new urologic alternative payment models oProvide resources on issues such as preauthorization tools, Quality Payment Program
What AUA Can Do For You
Public Policy & Practice Support Division
What We Can Do For Our Specialty
Patient and Research Advocacy oBring in our perspective to the rest of the urologic community.
Government Relations and Advocacy oProvide expert analysis of healthcare policy, become trained advocates
Practice Management oBring issues that may uniquely affect us to Practice Management oBecome stewards of our Specialty
Regulation & Reimbursement oInvolve ourselves in urologic alternative payment models oWork with AUA on issues that are going to impact our patients with ACA reform
What We Can Do For Our Specialty