Health Policy and Advocacy

As the leading voice of independent urology group practices in the US, LUGPA educates policymakers on the benefits of integrated urologic care. Our members drive grassroots efforts by developing thoughtful analysis and engaging public officials through comment letters on major legislative and regulatory proposals.


Health Policy May 2022 Update - New! 
May. 6, 2022

In this issue we feature:

  • Fly-in Recap
  • Public Health Emergency extended  
  • Telehealth flexibilities extended for most of 2022  
  • Radiation Oncology payment model delayed
  • No Surprises Act Updates 
  • LUGPA suggestion adopted by GOP Healthy Future Task Force
  • CMS Reweights 2021 MIPS Cost Performance Category

Click here to read the entire bulletin.  


Members of Congress Need to Hear from You!
LUGPA DC Fly-In Dates 
Lawmakers are most responsive when they hear from physicians from their districts and states. That’s why we encourage your group to send a physician and/or senior administrator to Washington, DC to attend our Capitol Hill visits with the LUGPA Political Affairs Committee.

Fly-in dates for 2022 have been set for April 5-6, June 14-15, and July 19-20.  Read a recap of our last fly-in here

If you are interested in attending a LUGPA fly-in, virtual fly-in, or if you would simply like more information, please contact Morgan Cox in the LUGPA office at [email protected].

2022 FEDERAL LEGISLATIVE AND REGULATORY PRIORITIES

Maintain patient access to physician administered cancer therapy through Medicare Part B. Physician practices that administer Part B drugs should not be put at risk for pricing decisions by manufacturers and Congress.  Congress can achieve the same amount of savings for Medicare and patients without upending the reliable buy-and-bill reimbursement system by collecting a rebate directly from pharmaceutical manufacturers.  This solution has the support of the entire provider community and does not impair Congress’s desire to reduce drug costs. [Read more]

Make pandemic-related telehealth waivers permanent.  In the first COVID relief package passed by Congress in March 2020, CMS was given the authority to remove restrictions for Medicare telehealth services.  This was done through regulatory waivers that lifted geographic restrictions and allowed for a range of telehealth services including new and established patient visits via smartphones or audio-only. CMS, however, is limited by statute and making these changes permanent will require Congressional action. LUGPA will be working with others in the physician community and with patient groups to advance legislation that will make these critical telehealth flexibilities permanent.

Promote neutrality of physician reimbursement regardless of site of service. Hospital systems are often compensated substantially more than physicians by Medicare for identical services. LUGPA is focused on Capitol Hill and in the administration on levelling the playing field between hospital and independent physician reimbursement, in order to ensure that independent physician practices can compete with hospital systems and continue to provide less costly, high quality care in patients’ communities. [Read more]

Promote Stark reform to allow independent practices to thrive under MACRA while maintaining the IOASE. After years of leading the physician community in advocating reform of the outdated and burdensome Stark self-referral laws, in November 2020 the Trump Administration issued a final rule implementing a substantial regulatory overhaul of that law, adopting many of LUGPA’s recommendations. The Stark Final Rule establishes a series of new exceptions to Stark’s self-referral prohibitions to protect value-based arrangements. Previously these exceptions have been tilted towards large hospital systems, but these new reforms will help level the playing field and give independent practices more flexibility to enter into value based care arrangements in the future. LUGPA will be carefully monitoring the implementation of these regulations during the coming year, while continuing to defend the “In-Office Ancillary Service Exemption” which allows the integrated delivery of care by physician practices under the fee-for service system. [Read more]

Ensure the rights of prostate cancer patients to secure access to genetic testing.  Several Medicare MACs have modified their LCDs such that they now substantially deviate from NCCN and other consensus guidelines. LUGPA supports the bipartisan Reducing Hereditary Cancer Act, legislation which would expand Medicare to cover screening for individuals with a family history of hereditary cancer, and to provide coverage of certain cancer screenings or preventive surgeries that would reduce the risk for individuals with a germline mutation associated with a high risk of developing a preventable cancer.

Closely monitor CMS’s implementation of legislatively mandated radiation therapy bundles to ensure patient access to cancer treatment. LUGPA helped secure legislation that allayed proposed draconian cuts to radiation therapy in the physician office setting in 2015. That legislation required CMS to create a bundled payment for radiation services.  As a result, CMS has developed the Radiation Oncology Alternative Payment Model.  LUGPA has consistently engaged in the rule-making process as CMS developed the model. [Read more]

Monitor regulatory implementation of MACRA and other value based care initiatives. CMS has taken a go-slow approach on MACRA implementation that has resulted in very little upside reward for high performing practices, including many LUGPA member practices.  LUGPA will encourage CMS to reward high performers in MIPS and approve more APMs so that our practices can participate. [Read more]