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.


LUGPA COVID-19 Advocacy Efforts
LUGPA’s Health Policy and Political Affairs Committees have been at the forefront of COVID-19 related issues relevant to LUGPA members.  Click here to see a summary of LUGPA's coronavirus-related advocacy efforts. 

Members of Congress Need to Hear from You!
LUGPA DC Fly-In Dates Announced for 2020
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.
Read more about the 2020 Fly-In dates.

2020 FEDERAL LEGISLATIVE AND REGULATORY PRIORITIES

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 and ensure that independent physician practices can compete with hospital systems and continue to 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. Policymakers would like physician practices to engage in value-based care such that practices assume risk and improve clinical outcomes through “Alternative Payment Models (APM’s).” Yet antiquated Stark and associated anti-kickback statutes (“AKS”) represent a barrier to the development and adoption of value based care models by independent physicians. CMS and the Office of the Inspector General at HHS have issued proposed rules that would comprehensively modernize the application of the Stark and AKS, making them much more workable for physician practices who are engaged in value-based care delivery. LUGPA strongly endorses these administration actions. LUGPA will be working with the administration and Congress to finalize these reforms, which will promote our practices’ ability to engage in value-based care delivery. LUGPA also continues to support enactment of bipartisan legislation (H.R. 2281/S. 966) that would permit our practices to test and participate in APMs, without current prohibitions. 

LUGPA will continue 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]

Continue to monitor and provide comments to CMS regarding policies that affect Medicare fee schedules. CMS is exploring substantial changes to the Medicare physician fee schedule that have disparate impacts on different physician specialties. LUGPA will advocate for policies that benefit our practices and urology patients.  [Read more]

Maintain patient access to physician administered cancer therapy through Medicare Part B. The Trump Administration has proposed revising reimbursement for physician administered drugs under Medicare. In an Advanced Notice of Proposed Rule Making, the administration proposed a demonstration project whereby “buy-and-bill” would be eliminated in half of the country and replaced with a new system that could limit physician choice of pharmaceuticals for their patients. Moreover, Congress is considering revisions of the “buy-and-bill” system that could harm patients’ access to drug therapies (particularly some forms of immunotherapy). LUGPA is committed to ensuring appropriate patient access to pharmaceuticals in the independent physician office, and will vigorously promote policies that keep patient access front and center. [Read more]

Closely monitor CMS’s development of legislatively mandated radiation therapy bundles to ensure patient access to cancer treatment. LUGPA helped secure legislation that resulted in a payment freeze to proposed cuts to radiation therapy in the physician office setting in 2015. That legislation required CMS to develop a bundled payment for radiation services, and CMS has recently engaged in proposed rulemaking to accomplish this. LUGPA is has concerns about several aspects of the proposed rule, including its scope, timing, and reimbursement methodology. LUGPA has and will continue to engage with CMS leadership on the proposed radiation therapy rule to ensure that the bundle adequately protects patient access to care. [Read more]

Monitor regulatory implementation of MACRA. 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 members) for those who had made investments and performed well. LUGPA will encourage CMS to reward high performers in MIPS and approve more APMs that our practices can participate.  [Read more]