LUGPA 2024 Annual Meeting: Health Policy and Advocacy Recap

LUGPA’s 2024 Annual Meeting showcased major advocacy achievements and set the tone for future efforts. Highlights included progress in physician payment reform, with bipartisan legislation to prevent cuts and promote sustainable reimbursement under the Medicare Physician Fee Schedule. Members were introduced to the new MIPS Value Pathway for urology, designed to improve care quality across conditions like kidney stones and prostate cancer while reducing administrative burdens. Additionally, the advocacy presentation highlighted LUGPA’s 2024 fly-ins, which strengthened our relationships with lawmakers and advanced key priorities, including site neutrality, streamlined MACRA requirements, and drug payment protections. These accomplishments underscore LUGPA’s commitment to securing policies that support independent practices and enhance patient care.

Access the slides from this session here.  Below is a recap of the key topics covered:

Physician Payment Reform

LUGPA worked closely with Congress to address urgent needs in physician payment reform:

• Congressional Actions: Senate and House committees focused on MACRA and PTAC reforms, budget neutrality adjustments, and updates based on the Medicare Economic Index.
• Bipartisan Legislation: The Doctors' Caucus introduced bipartisan legislation aimed at preventing a 2.8% payment cut.
• Medicare Physician Fee Schedule: CMS phased in proposed cuts for cystoscopy procedure reimbursement over four years, avoiding a sudden, drastic reduction in office-based payments.

MIPS Value Pathway for Urology

A new MIPS Value Pathway (MVP) for urology now emphasizes optimal care across urologic conditions, from kidney stones to prostate cancer. LUGPA continues to push for MIPS/MACRA reforms to make it easier for independent practices to participate and innovate.

2024 DC Fly-Ins: Advocacy in Action

In 2024, LUGPA held two fly-ins in Washington, D.C., to advance our agenda:

• March Fly-In: We advocated for sustainable Medicare reimbursement, streamlined MACRA requirements, and improved access to medications under the Seniors Access to Critical Medications Act.
• July Fly-In: We continued efforts around fair reimbursement, site neutrality, and Part B drug payment protections.

These fly-ins strengthened relationships with key lawmakers and allowed members to advocate directly on issues critical to independent urology.

Legislative Wins: Site-Neutral Payment Reform, In-Office Dispensing & Cancer Therapies

LUGPA supported several key bills:

• Site-Neutral Payment Reform: HR 5378, the Lower Costs, More Transparency Act, which aligns Medicare payments for drug administration services in off-campus hospital outpatient departments (HOPDs) with payments for freestanding physician offices, passed the House, advancing our goal to ensure fair reimbursement rates regardless of care setting.
• Cancer Therapy Access: LUGPA endorsed HR 5391/S. 2764, which prevents severe reimbursement cuts for Part B drugs by instituting a manufacturer rebate system.
• In-Office Dispensing: In September, the House passed HR 5526, a bipartisan bill that aims to improve access to critical medications for patients with serious illnesses by allowing mail-order dispensing, allowing family members to pick up medications and clarifying the Stark Law to show that delivering medications through various methods does not violate the Stark Law. The bill would also safeguard in-office pharmaceutical services, which are crucial for patient-centered care.

Upcoming Legislation to Watch

In the coming months, LUGPA is tracking several end-of-year bills, including:

• PBM Transparency: Increased reporting requirements on PBMs to ensure drug pricing clarity.
• Cost-sharing Caps and Prior Authorization Reforms: Key bills in the House and Senate.
• HR 10073 (Murphy’s Medicare Patient Access and Practice Stabilization Act): This bill would eliminate the planned 2025 2.8% cut and provide a 1.9% increase, resulting in a 4.73% net gain for physician payments.

The Path Forward

LUGPA's 2024 advocacy accomplishments lay a strong foundation for continued success in ensuring fair reimbursement, supporting independent practices, and advancing patient-centered care. These efforts underscore our commitment to shaping a sustainable and effective healthcare system.

Political Action and Fundraising

January marks the start of a new fundraising cycle and campaign to support LUGPA’s advocacy priorities . Your individual contributions are vital to sustaining our momentum in Washington, D.C. and strengthening our relationships with key lawmakers. Together, we can ensure that the voices of independent urology practices are heard loud and clear.  If you are interested in receiving more information about how you can participate, please email Matt Glans at [email protected].

Keynote Speakers Encourage LUGPA Member Involvement at Annual Meeting

At the Annual Meeting, Dr. Brian Miller and former House Speaker Kevin McCarthy offered compelling perspectives on the challenges of healthcare consolidation and opportunities for reform. Read more here.