July 2022 In this issue we feature:
Fly-in Recap The Political Affairs Committee and LUGPA members were back in Washington, DC in June as we continued to promote our 2022 Legislative and Regulatory Agenda. This fly-in focused on three key issues: making telehealth waivers permanent; protecting physician practices in any drug pricing reform of physician-administered Part B drugs; and advancing site neutrality policies that level the playing field between physician practices and hospitals. We are getting great traction on our issues. The GOP Healthy Futures Task force, which is outlining an agenda for the next Congress should Republicans retake the House of Representatives, has adopted our ideas on site neutrality for Part B drug administration reimbursement and beneficiary copayment caps between physician office and hospitals, as well as reforming the inpatient only list. In June, LUGPA members met with the following Members of Congress:
In addition to the lawmakers listed above, fly-in participants met with health aides and staff members of the House Ways and Means and Energy and Commerce Committees and the Senate Finance Committee. We have another batch of meetings scheduled for some of our physician leaders next week and hope to make even more progress on the advocacy front, particularly as it pertains to reimbursement. Last week CMS released its proposed physician fee schedule rule, which included substantial cuts to physician reimbursement. We will be working with others in the physician community to block these cuts and provide a sustainable annual payment update. LUGPA encourages members to attend fly-ins to let Members of Congress and their staff know what is going on in your practices. LUGPA physicians and senior administrators who have attended in the past say that they find the experience to be worthwhile and essential to their understanding of the political process. If you are interested in attending a fly-in with LUGPA in Washington, DC, or would like more information, contact the LUGPA office. With the utmost gratitude, the LUGPA Political Affairs committee wants to thank the physicians and administrators of the following groups whose efforts made the June fly-in possible: AAUrologyAdvanced Urology Medical Arkansas Urology Associated Urologists, PA Dayton Physicians Network First Urology Garden State Urology Genesis Healthcare Partners Golden Gate Urology MidLantic Urology NEO Urology Premier Medical Group of the Hudson Valley The Urology Group Urological Surgeons of Northern California, Inc. Urology Associates of Central California Urology Associates of the Central Coast Urology of Indiana
LUGPA and coalition oppose use of step therapy and prior authorization in Medicare Part B LUGPA has joined more than 70 provider and patient organizations urging CMS to change current policy that allows for the use of step therapy and prior authorization protocols to manage drug utilization by Medicare Advantage plans. This is an issue LUGPA has focused on, as there are concerns that patients are at risk under “fail-first” step therapy requirements. LUGPA opposes any policies that restrict appropriate access to drugs, including step therapy and prior authorization and will continue to work with aligned stakeholders in urging CMS and Congress to reverse current CMS policy. Read the sign-on letter here.
Additional LUGPA recommendations adopted by GOP Healthy Futures Task Force In June, the Doctor-Patient Subcommittee of the GOP Healthy Futures Taskforce has released recommendations which pick up some of LUGPA’s legislative priorities, including less bureaucracy for prior authorization and step therapy, specifically:
FTC launches investigation into PBMs On June 7, the Federal Trade Commission announced a formal inquiry into the role of PBMs in the pharmaceutical marketplace after a unanimous vote from its commissioners. The agency has ordered the six largest pharmacy benefit managers to provide information and records on their business practices in order to scrutinize their impact on the accessibility and affordability of prescription drugs. Specifically, the inquiry will focus on:
The full statement is available on the FTC website.
Medicare payments decrease by 1% effective July 1 The 2% payment cut temporarily suspended in 2020 and 2021 due to COVID relief packages has been phased back in. The reduced rate is effective for services provided on or after July 1.
Phase 3 Provider Relief Fund reporting is now open The Provider Relief Fund Reporting Portal for Phase 3 is now open. Providers who received one or more Provider Relief Fund payments exceeding $10,000 in aggregate between January 1 and June 30, 2021 are required to report their use of funds by September 30.
No Surprises Act Information and Resource Hub As a reminder, LUGPA has assembled a page of helpful links and resources to assist urology practices in the implementation of the No Surprises Act. The page is frequently updated with new information as it becomes available. Among the latest updates are two recent presentations:
Click here to access the No Surprises Act Information and Resource Hub.
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2024 Annual Meeting Recap
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LUGPA Launches Training Course for Medical Assistants
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