LUGPA Returns to Washington: October DC Fly-In Recap 

In October, LUGPA hosted its final DC Fly-In of 2023, when members converged in Washington, DC, to advocate for critical healthcare reforms outlined in the 2023 Legislative and Regulatory Agenda. Here's an overview of the key issues discussed:

     
      In this video, shown at the LUGPA Annual Meeting in Orlando, Fly-In participants talk
about their experiences and the importance of talking to legislators face-to-face.
  1. Preserving Physician Payment: A significant point of concern was the impending 3.3% reduction in the Medicare Physician Fee Schedule for 2024. This issue had been an ongoing focus for LUGPA, as members emphasized the need for lasting reforms in the Medicare Access and CHIP Reauthorization Act (MACRA) and the fee schedule. LUGPA's consistent advocacy centers on achieving equitable Medicare funding for independent healthcare providers, given the existing preferences for hospital-based providers.
  2. Expanding In-Office Dispensing: Another focal point was expanding regulations to permit the delivery of cancer drugs to patients through in-office dispensing.
  3. Protecting Physician Reimbursement: LUGPA urged the preservation of physician reimbursement at ASP+6%, irrespective of new drug price controls outlined in the Inflation Reduction Act.
  4. Reforming the 340B Program: LUGPA advocated for reforms to enhance the 340B Program's effectiveness, ensuring that it fulfills its intended purpose of providing care to those in need. The organization recommended implementing transparency requirements to monitor the resale of 340B drugs, quantifying provider profits from the program, and strengthening eligibility criteria, demanding a specific level of charitable care spending (e.g., at least 3.8% of spending) to qualify for 340B discounts.

Challenges Amid Historic Speaker Vote

     

LUGPA's October fly-in coincided with the historic Speaker vote, presenting unique challenges for our advocacy efforts. The political landscape was particularly dynamic, with many lawmakers engrossed in the selection of a new Speaker of the House. This added an additional layer of complexity to LUGPA's mission, as it required navigating a politically charged atmosphere while advocating for critical healthcare reforms. However, LUGPA's members rose to the occasion, engaging with lawmakers to ensure their voices were heard amidst this significant political event, underscoring their unwavering commitment to championing policies that benefit independent medical practices and enhance patient care.

Advocating for LUGPA’s Policy Priorities

During the two-day fly-in, LUGPA members engaged in discussions with lawmakers, addressing many of our top healthcare issues. Lawmakers were informed of the dire need to reform the Medicare fee schedule and the co-sponsorship of the "Strengthening Medicare for Patients and Providers Act" (HR 2474) that ties payments to the Medicare Economic Index.

The looming 3.3 percent reduction scheduled for January 1 raised significant apprehension among several members, who emphasized the urgency of implementing long-term reforms to the Medicare Access and CHIP Reauthorization Act (MACRA) and the fee schedule. LUGPA has consistently advocated for fair Medicare funding and a level playing field for independent healthcare providers, given the existing regulations favoring hospital-based providers. During our meetings, we learned that similar efforts are underway in the Senate to address provider reimbursement and new proposed bills may be introduced soon.

Another focus was the federal government's initiatives to reduce drug prices, particularly the Inflation Reduction Act's impact on healthcare providers. The proposed cuts in reimbursements for Part B and Part D drugs raised significant concerns, particularly regarding the 6% add-on payment for Part B drug administration.

     

Under the Inflation Reduction Act, Medicare intends to decrease reimbursements for Part B and Part D drugs by a minimum of 35 percent, with no price floor; the Congressional Budget Office anticipates a 50 percent reduction. These cuts raised particular concerns for independent providers as their reimbursement is linked to the 6% add-on payment for Part B drug administration, potentially endangering patient access to essential therapies. LUGPA discussed a new bill with lawmakers designed to address these concerns.

LUGPA discussed the "Protecting Patient Access to Complex Therapies Act" (S.2764) (H.R. 5391) with lawmakers, aimed at maintaining physician reimbursement at ASP+6% and facilitating cost-effective access to vital medications.

Advocating for legislative reform to protect in-office dispensing was the third prominent issue. LUGPA voiced strong support for integrating pharmaceutical dispensing into physician practices, emphasizing the benefits in care coordination, patient compliance, and overall health outcomes.

One additional bill, introduced right before our last fly-in in September, became another focal issue in October. This bipartisan bill addresses many of LUGPA's concerns and is the "Seniors’ Access to Critical Medications Act" (HR 5526). Introduced by Reps. Harshbarger and Wasserman-Shultz, this bill seeks to clarify the Stark law, allowing various delivery methods, and calls for revisions to CMS interpretations and the rescinding of FAQs that restrict medicine delivery.

Promoting Independent Medicine

Throughout the DC Fly-In, LUGPA engaged with policymakers on several other healthcare-related topics, including telehealth reimbursement parity, the prominent site of service reimbursement differential between hospital and independent providers, the extension of telehealth waivers beyond the public health emergency, and the challenges posed by healthcare consolidation and price increases.

These efforts underscore LUGPA's dedication to advocating for policies that benefit independent medical practices and enhance patient care and access.

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

  • * Rep. Diana Harshbarger (R-TN) | A pharmacist, House Energy and Commerce Health Subcommittee Member
  • * Sen. Roger Marshall (R-KS) | Member of Health, Education, Labor, & Pensions Committee
  • * Sen. Thom Tillis (R-NC) | Member of Committee on Finance
  • *Rep. Linda Sanchez (D-CA) | Member of Committee on Ways and Means
  • * Rep. Teri Sewell (D-AL) | Member of Committee on Ways and Means
  • * Rep. David Kustoff (R-TN) | Member of Committee on Ways and Means
  • Sen. Van Hollen (D-MD)| Member of Committee on Appropriations
  • Sen. Chris Coons (D-DE) | Member of Committee on Appropriations
  • Rep. Glenn Ivey (D-MD) | Member of House Judiciary Committee
  • Rep. Dwight Evans (D-PA) | Member of House Judiciary Committee
  • Rep. Lisa Blunt Rochester (D-DE) | Member of Committee on Energy and Commerce
  • Rep. Paul Tonko (D-NY) | Member of Committee on Energy and Commerce
  • Rep. Steve Cohen (D-TN) | Member of House Judiciary Committee
  • Rep. Jennifer Wexton (D-VA) | Member of Committee on Appropriations
  • Rep. John Sarbanes (D-MD) | Member of Committee on Energy and Commerce
  • Rep. Abigail Spanberger (D-VA) | Member of Committee on Agriculture        
  • Rep. Sharice Davids (D-KS) | Member of Committee on Agriculture
  • Rep. Jamie Raskin (D-MD) | Member of Rules Committee
  • Rep. Mark Green (R-TN) | Chairman of the Committee on Homeland Security
  • Rep. Mike Kelly (R-PA) | Member of Committee on Ways and Means
  • Rep. Elise Stefanik (R-NY) | Member of the Committee on Education and the Workforce
  • Rep. Chuck Fleischmann (R-TN) | Member of Committee on Appropriations
  • Rep. Marcus Molinaro (R-NY) | Member of Committee on Agriculture
  • Rep. Guy Reschenthaler (R-PA) | Member of Committee on Appropriations
  • Rep. Jake LaTurner (R-KS) | Member of Committee on Appropriations
  • Rep. Morgan Griffith (R-VA) | Member of Committee on Energy and Commerce
  • Rep. Michael Burgess (R-TX) | Member of Committee on Energy and Commerce
  • Sen. Jerry Moran (R-KS) | Member of Committee on Appropriations
  • Sen. Bill Hagerty (R-TN) | Member of Committee on Appropriations
  • Rep. Robert Wittman (R-VA) | Member of House Armed Services Committee
  • Rep. August Pfluger (R-TX) | Member of Committee on Energy and Commerce

*Indicates Member Meeting

 

Your Participation Matters!

We urge all LUGPA members to plan to attend next year's fly-ins, as your presence is crucial in advocating for healthcare reforms that impact independent medical practices and the patients we serve. We also encourage members of our advocacy donor groups to join us, as your support and insights are invaluable.

Your presence and perspectives enrich our advocacy efforts. Together, we can continue to significantly impact healthcare reform and ensure that the voice of independent practices is heard. Join us in bringing about positive change in the healthcare landscape. Those interested in attending a fly-in with LUGPA in Washington, DC, or seeking more information can contact Matthew Glans at [email protected].

A Thank You From LUGPA

With deep appreciation, the LUGPA Political Affairs Committee thanks the physicians and administrators of the following groups for their invaluable contributions to the October fly-in:

  • Anne Arundel Urology, PA
  • Comprehensive Urology
  • Urology of St. Louis, Inc
  • Urology Nevada, LLC
  • Greater Boston Urology
  • Rio Grande Urology
  • First Urology, PSC
  • Urology San Antonio
  • Urology of Indiana
  • Urologic Specialists of Northwest Indiana, LLC
  • Conrad Pearson Clinic

We also thank the LUGPA members who attended the October fly-in for their commitment to promoting LUGPA's mission and advocacy efforts. Your dedication is commendable.

  • Dr. Josh Langston, Urology of Virginia
  • Mr. Nathan Diller, Brandywine Urology
  • Dr. John Adams, Conrad Pearson
  • Dr. Ronald Kaufman, Albany Medical College
  • Dr. Jay Gilbaugh, Wichita Urology
  • Dr. Fei Lian, AA Urology