LUGPA Announces Support for Legislation to Enhance Medicare Care Coordination

 

LUGPA Announces Support for Legislation to Enhance Medicare Care Coordination

New Legislation Promotes Stark Law Modernization to Advance Value-Based Care

CHICAGO, Ill., November 2, 2017 – LUGPA, the leading association for urologists in independent practice, today announced its support for The Medicare Care Coordination Improvement Act of 2017. This legislation, introduced with bipartisan support in both the United States Senate and House of Representatives, removes regulatory barriers to value-based care delivery by physician practices. The bill grants physicians the ability to develop and test novel payment paradigms in value-based care models as well as provide care under ACO waivers.

“The introduction of Stark modernization legislation is a critical milestone in our efforts to improve the ability of independent practices to deliver quality, accessible care,” said Neal D. Shore, MD, FACS, president of LUGPA. “LUGPA applauds the Members of the U.S. House and Senate who have taken the leadership on this issue.”

The Medicare Care Coordination Improvement Act (H.R. 4206) was introduced in the House by Representatives Larry Bucshon, MD (R-IN), Ron Kind (D-WI), Kenny Marchant (R-TX) and Raul Ruiz, MD (D-CA). Senators Rob Portman (R-OH) and Michael F. Bennet (D-CO) introduced the legislation (S. 2051) to the Senate.

“Large health systems were granted waivers from Stark Laws to establish ACOs years ago, but those protections were not extended to physicians in independent practice, which excluded the most cost-effective site of service from participating in value-based care models” said Dr. Shore. “This legislation is an important step in the right direction to leveling the playing field and allowing patients the ability to access high quality care at the location of their choosing.”

Results of this legislation were outlined in a letter signed by representatives of the physician community, including LUGPA. The key provisions they noted from “The Medicare Care Coordination Improvement Act of 2017” would:

1. Provide CMS the same authority to waive prohibitions in the Stark Law and Anti-Kickback Statute for physicians seeking to develop and operate APMs as was provided to Accountable Care Organizations in the Affordable Care Act.

2. Remove the “volume or value” prohibition in the Stark Law for physician practices that are developing or operating alternative payment models (including, Advanced APMs, APMs approved by the Physician-Focused Payment Model Technical Advisory Committee, MIPS APMs and other APMs specified by the Secretary). This will enable physician practices to align incentives for their physicians to abide by best practices and succeed in the new value-based alternative payment models.

3. Ensure that CMS’s use of its current administrative authority promotes care coordination, quality improvement and resource conservation.

LUGPA encourages its members, and all physicians in independent group practice, to contact their Representatives and Senators and urge them to co-sponsor this legislation. Visit USA.gov to find your elected officials and ask them to support the Medicare Care Coordination Improvement Act of 2017.

About LUGPA

LUGPA is a trade association that represents independent urology group practices in the U.S., with more than 2,300 physicians who make up more than 25 percent of the nation’s practicing urologists, and provide more than 30 percent of the total urologic care in the U.S. The association is committed to providing the best resources and information for its member practices through advocacy, research, data collection and benchmarking efforts. LUGPA advocates for independent urology practices by promoting quality clinical outcomes, fostering new opportunities and improving advocacy in the legislative and regulatory arenas. For more information, visit lugpa.org.