September 2023 Washington, DC Fly-In Recap

In September, the Political Affairs Committee and members of LUGPA returned to Washington, DC, to promote the 2023 Legislative and Regulatory Agenda. The fly-in focused on four key issues:


Left to right: Dr. Taylor Moore, MD, Dr. Clayton Hudnall, MD, Dr. Joshua
Langston, MD, John McManus, Congressional Staff Member, Dr. Gary Kirsh, MD,
and Representative Bill Johnson.

  1. Supporting Physician Payment in the face of a planned 3.3% cut to the Medicare Physician Fee Schedule in 2024
  2. Expanding regulations for in-office dispensing to allow for the delivery of cancer drugs to patients
  3. Preserving physician reimbursement at ASP+6% regardless of new drug price controls under the Inflation Reduction Act
  4. Promoting site neutrality for Medicare payments, leveling the playing field for independent providers

LUPGA's September DC Fly-In occurred amidst a challenging period for members of Congress, marked by looming funding issues that could potentially lead to a government shutdown. These challenges arise from differences among lawmakers regarding the allocation of federal funds, especially concerning critical policy priorities. With the deadline for a funding resolution approaching, concerns are growing that failing to reach a compromise could result in a partial or complete shutdown of government services, affecting various sectors and agencies. Legislators are actively engaged in negotiations and discussions to hopefully avert such a scenario and ensure the continued, uninterrupted operation of the federal government.

Despite this pressing matter, LUGPA members held several productive meetings with lawmakers, addressing various vital issues. These discussions covered topics such as Medicare funding, MIPS/MACRA reform, healthcare workforce concerns, rising drug costs, site neutrality, payment differentials between hospitals and independent providers, value-based care, and prior authorization.

During the two-day fly-in, specific issues took precedence in conversations with lawmakers. Firstly, members discussed a recurring concern from their July fly-in regarding the Centers for Medicare and Medicaid Services' proposed rule for the physician fee schedule. A 3.3 percent cut is anticipated on January 1 unless legislative changes occur. Several members expressed their apprehension about these cuts and stressed the need for long-term reforms to MACRA and the fee schedule.

LUGPA has consistently advocated for improving Medicare funding and leveling the playing field for independent providers, who currently face rules favoring hospital-based providers. During the September fly-in, LUGPA members requested lawmakers and their staff to co-sponsor the "Strengthening Medicare for Patients and Providers Act" (HR 2474), which links payments to the Medicare Economic Index.

The second focal point of the fly-in centered on the federal government's efforts to reduce drug prices and their impact on healthcare providers. Under the Inflation Reduction Act, Medicare plans to reduce reimbursement for Part B and Part D drugs by a minimum of 35 percent, with no price floor; the Congressional Budget Office predicts a 50 percent reduction. These cuts are particularly concerning for independent providers as their reimbursement is tied to the 6% add-on payment for Part B drug administration, potentially jeopardizing patient access to essential therapies.

LUGPA discussed a new bill proposed to address these concerns in meetings with lawmakers. Sponsored by Senator Barrasso and Representatives Burgess and Murphy, the Protecting Patient Access to Complex Therapies Act (S.2764) (H.R. 5391) aims to preserve physician reimbursement at ASP+6%, eliminating their involvement in pricing negotiations and instead collecting a rebate from drug manufacturers equal to the price cut. Patients' co-insurance would be based on the rebated drug price, ensuring seamless access to vital medications while achieving cost savings for the Medicare program.

The third issue that gained prominence during meetings involved advocating for legislative reform to safeguard in-office dispensing. LUGPA strongly supports the integration of pharmaceutical dispensing into physician practices, recognizing its significant advantages in care coordination, patient compliance, and overall health outcomes. In previous congressional advocacy, LUGPA recommended three critical actions for regulatory reform: retracting the problematic CMS FAQ that restricts access to prescribed medications through in-office dispensing, preserving the In-Office Ancillary Services Exception (IOASE) within the Stark Laws, and endorsing legislation to formalize these reforms.

On September 18, just one day before our fly-in, a new bipartisan bill was introduced to address many of LUGPA’s concerns—the Seniors’ Access to Critical Medications Act (HR 5526), introduced by Reps. Harshbarger and Wasserman-Shultz. This bill would clarify the Stark law, allowing various methods of delivering medicines without violating Stark regulations, including mail, courier services, or family members or caregivers picking up medication on behalf of a patient.

The bill also calls for CMS to revise its interpretation of the existing law that restricts medicine delivery to patients not physically present in a physician’s office. Additionally, the bill seeks to rescind two FAQs issued by CMS on this matter. LUGPA strongly supported this bipartisan legislation and advocated for its co-sponsorship in meetings with lawmakers. Many offices expressed interest in the bill, and we will continue working with them in the coming weeks.

In September, LUGPA members met with the following Members of Congress and their healthcare staff:

  • *Representative August Pfluger (R-TX) | Member of House Energy and Commerce Committee
  • Sen. J.D. Vance (R-OH) | Member of the Committee on Banking, Housing, and Urban Affairs
  • Sen. John Boozman (R-AR) | Member of Committee on Appropriations
  • *Representative Greg Murphy (R-NC) | A practicing urologist and member of the House Ways and Means Subcommittee on Health, Doctors Caucus
  • *Representative Bill Johnson (R-OH) | Member of House Ways and Means Committee
  • *Representative Suzan DelBene (D-WA) | Member of House Ways and Means Committee
  • *Representative Raul Ruiz (D-CA) | An emergency room physician, House Energy and Commerce Health Subcommittee Member
  • *Representative Kim Schrier (D-WA) | A pediatrician, House Energy and Commerce Health Subcommittee Member
  • Representative Nicole Malliotakis (R-NY) | Member of House Ways and Means Committee
  • Representative Jason Smith (R-MO) | Member of House Ways and Means Committee
  • Representative Jen Kiggans (R-VA) | Member of Committee on Veterans' Affairs Health Subcommittee
  • Representative Diana Harshbarger (R-TN) | A pharmacist, House Energy and Commerce Health Subcommittee Member
  • Representative Chip Roy (R-TX) | A member of the House Rules Committee
  • Representative French Hill (R-AR) | A member of the House Financial Services Committee
  • Representative Claudia Tenney (R-NY) | Member of House Ways and Means Committee
  • Sen. Roger Marshall (R-KS) | Member of Health, Education, Labor, & Pensions Committee
  • Representative Al Green (D-TX) | Member of the House Committee on Financial Services
  • Representative Lloyd Doggett (D-TX) | Member of House Ways and Means Committee
  • Representative Pat Ryan (D-NY) | Member of House Armed Services Committee
  • Representative Jennifer McClellan (D-VA) | Member of House Armed Services Committee
  • Representative Brian Higgins (D-NY) | Member of House Ways and Means Committee
  • Representative Bobby Scott (D-VA) | Member of Committee on the Budget
  • Representative Lizzie Fletcher (D-TX) | Member of House Energy and Commerce Committee
  • Representative Grace Meng (D-NY) | Member of Committee on Appropriations
  • Representative Don Beyer (D-VA) | Member of House Ways and Means Committee

*Indicates Member Meeting

LUGPA encourages its members to attend these fly-ins to keep Members of Congress and their staff informed about the challenges faced in their practices. Those interested in attending a fly-in with LUGPA in Washington, DC, or seeking more information can contact Matthew Glans at [email protected]. The next fly-in is scheduled for October 24-25.

With the utmost gratitude, the LUGPA Political Affairs committee wants to thank the physicians and administrators of the following groups whose efforts made the July fly-in possible:

  • Kansas City Urology Care
  • Urology Specialist Group
  • Advanced Urology Institute
  • Amarillo Urology Associates
  • Houston Metro Urology
  • Wichita Urology Group
  • Golden Gate Urology
  • Idaho Urologic Institute
  • NEO Urology Associates
  • Associated Urologists, PA
  • Urological Surgeons of Northern California
  • Genesis Healthcare Partners
  • Urology Associates of the Central Coast
  • Minnesota Urology
  • The Urology Center of Colorado