Washington Roundup

LUGPA News Washington Roundup R. Jonathan Henderson, MD President, LUGPA; Regional Urology, LLC, Shreveport, LA [Rev Urol. 2020;22(4):168–169] © 2021 MedReviews®, LLC M ost urologists see the title “Washington Roundup” and flip to the next page. I am more interested in the Washington, DC, side of LUGPA’s efforts than your average urologist. I might even say that is why I got involved with LUGPA in the first place. I have been on the LUGPA Board for more than 10 years and became LUGPA president at the November 2020 Annual Meeting. Until recently, I also served as the Health Policy Chair for the American Association of Clinical Urologists (AACU). Many LUGPA members adopt the attitude that they would rather leave advocacy to the experts. You can sleep well knowing that LUGPA’s Health Policy and Political Affairs Committees have it covered! If, however, you are interested in government relations and health policy, please e-mail Morgan Cox at mcox@lugpa.org. We are always looking for motivated people to join us on our visits to Capitol Hill. Here are some recent LUGPA activities that affect practices like yours. LUGPA Victory Regarding Site-neutral Payments Paycheck Protection Program Court Upholds 340B Hospitals’ Medicare Part B Drug Reimbursement Cuts In June, President Trump signed the Paycheck Protection Program Flexibility Act of 2020 into law. This legislation modified certain provisions related to the forgiveness of loans made to small businesses under the Paycheck Protection Program. LUGPA acted swiftly to communicate everything independent urology groups needed to know about this program and how to take advantage of its benefits. Perhaps the biggest news from the past few months is that the US Court of Appeals ruled in favor of siteneutral payments. This is a big win for LUGPA and independent practices. Large healthcare systems have been benefitting from an unfair reimbursement system that paid hospital outpatient departments as much as twice for the same service as independent physicians. LUGPA has been fighting this battle for a long time. Earlier this year, LUGPA and two other stakeholders filed an amicus curiae brief in support of the Secretary of Health and Human Services’ action to cap rates for hospital clinic visit services in the off-campus outpatient department setting. It appears LUGPA’s efforts may have influenced the July unanimous reversal, and I, for one, could not be happier. Although the hospital plaintiffs may file an appeal, this decision is a big win for independent practices that provide services to Medicare patients. Shortly after the victory described above, another ruling came through regarding Medicare Part B drug reimbursement for 340B hospitals. The 340B Drug Pricing Program enables safetynet hospitals, health centers, and clinics to purchase prescription medications at discounted prices. 168 • Vol. 22 No. 4 • 2020 • Reviews in Urology 4170020_06_RIU0886_V4_ptg01.indd 168 4/6/21 5:28 PM LUGPA News These covered entities then receive reimbursement for drugs purchased under the program at much higher rates than their acquisition costs. In recent years, critics have complained the 340B program was being abused by hospitals that were not using these excess profits to help underserved populations, contrary to the program’s original intent. In this new ruling, a panel of judges voted to affirm Centers for Medicare & Medicaid Services authority to change the outpatient prospective payment system to align reimbursement for drugs acquired under the 340B program more closely to hospital costs in acquiring those drugs. This is a win for LUGPA as LUGPA has been pushing for quite some time now to reform the 340B drug discount program so that it benefits uninsured and indigent patients, not mega-hospital systems. Price Transparency Dr. Richard Harris, LUGPA’s immediate past president, recently wrote a wonderful opinion in Morning Consult entitled “Now Is Price Transparency’s Moment.” He wrote, “… price transparency is critical if we are to ever level the playing field between hospitals and independent practices. If the country is serious about addressing the escalating cost of care, and we want to help patients make informed decisions about their care, it is time that patients have the chance to see the relative costs of health care offered in hospitals versus independent settings.” It is a complicated and nuanced topic, but Dr. Harris explains it very well. I urge you to read it at https:// morningconsult.com/opinions/ now-i s -pr ic e -t r a n s p a re nc y s moment/. Price transparency allows patients to assess and choose which healthcare services they receive based on cost and quality. When this data is transparent, patients can quickly see how independent practices provide higher quality and more affordable care than hospitals. LUGPA has sent comment letters to lawmakers, surveyed patients, and sent out press releases about this topic. Did you know that when surveyed, 91% of respondents said they believe hospitals and healthcare facilities should be required to publicly disclose the costs of their services? Additionally, 66% of respondents believe price transparency will improve healthcare. Stark Law and Antikickback Statute Unfortunately, not everything I have to report is good news. In August, there was a report that federal regulators planned to delay updates to the self-referral and anti-kickback laws until next year. LUGPA and its member practices have been championing the transition from fee-for-service to value-based care models since 2015’s bipartisan passage of the Medicare Access and CHIP Reauthorization Act of 2015. If true, this delay would be unfortunate for independent practices as a change is necessary to transform our healthcare system to one that pays for value. LUGPA will continue to stay on top of this situation. Passage of Veterans Prostate Cancer Act On September 22, 2020, the House of Representatives unanimously passed the Veterans Prostate Cancer Treatment and Research Act (H.R. 6092), which was supported by LUGPA. The bill provides funding for prostate cancer research and paves the way for a standardized clinical treatment for veterans with prostate cancer. Our political affairs and health policy teams were instrumental in getting this bill passed in the House, and as I write this, the bill is now in the Senate. Conclusion LUGPA continues as the leading advocate on behalf of independent urology groups and LUGPA’s Health Policy and Political Affairs Committees are working constantly to be sure that lawmakers don’t forget about independent practices. Vol. 22 No. 4 • 2020 • Reviews in Urology • 169 4170020_06_RIU0886_V4_ptg01.indd 169 4/6/21 5:28 PM