These two changes, if enacted, would cripple urologists’ ability to quickly and accurately diagnose and treat their patients, harming quality patient care.
Expansion of the MedPAC recommendation to all imaging modalities is wrong because:
- The utilization rate increase was only intended for high-cost imaging. In its March 2009 Report to Congress, MedPAC recommended that the Centers for Medicare & Medicaid Services (CMS) increase the utilization rate for advanced, expensive imaging services, which they defined as imaging equipment costing $1 million or more, mostly CT, MRI and PET scans, currently set at 50 percent. After conducting what they readily admit is a limited study, they determined that physicians use this equipment 90 percent of the time. Increasing the underlying assumption for utilization results in decreased reimbursement to you. The MedPAC data is not representative, particularly for rural areas, which the AUA’s own survey reveals have an actual utilization rate of 35-40 percent.
- Attention is being deflected away from the real issue. Radiologists are seeking to protect reimbursement for advanced imaging by expanding this recommendation to increase the utilization rate to 75 percent for all imaging modalities, including ultrasound. They are attempting to buy down the decrease in reimbursement by spreading it across all modalities.
- Ultrasound-guided biopsies save Medicare money. For example, an ultrasound-guided procedure, CPT Code 76942 (Ultrasonic guidance for needle placement, imaging supervision and interpretation), only costs Medicare $175, which is significantly less than an invasive, surgical biopsy.
- Ultrasound is extremely cost-effective. Decreasing the payment for ultrasound will not realize much in actual savings, but will cause severe hardship for urologists who rely on ultrasound to provide basic care. You know that ultrasound is the standard of care, the state-of-the art, the best practice.
Expansion of the MIPPA accreditation to ultrasound is wrong because:
- Urologists are well trained. Urologists who perform and interpret ultrasound studies are trained starting in their residency programs and that training is further reinforced by the Ultrasound Education Program supported by the AUA. The American Board of Urology, as part of certification, tests competence in all urologic imaging, including ultrasound, which is further enforced by Maintenance of Certification testing.
- Ultrasound is different from CT and PET scans. Unlike CT and PET scans, which utilize equipment that must be inspected to monitor radiation dosages, ultrasound only uses low intensity sound waves.
- Accreditation practices differ from CT, MRI and PET scans. The accreditation model of verifying the qualifications of the technologist performing the ultrasound does not apply to ultrasound services provided in urology offices by urologists.
- Image interpretation differs from CT, MRI and PET scans— For advanced imaging, images are not interpreted in real-time, requiring these labs to be inspected for processing to ensure that images are of high enough caliber to be accurately read at a later time.
Are you concerned yet? You better be – ultrasound is not the only target in Congress’ crosshairs!
- Do you want to still be able to use CT, MRI and PET scans? Legislation has been introduced which would remove advanced diagnostic imaging from the in-office ancillary exception to the Stark laws. This would effectively prevent urologists from performing CT, MRI or PET scans in their offices, effectively ensuring that only radiologists can perform them.
- Do you want to be forced to accept patients on the new “public plan?” Several of the healthcare reform bills in Congress want to mandate that any physician receiving Medicare MUST accept the public plan.
- Do you want to take money out of your wallet to pay for the increased payments to primary care physicians?Many in Congress want you to do just that. Several of the plans to increase the payments for primary care do so by reducing payments to specialists.
- Do you think that Congress is all you must worry about?Think again! There are several other groups that are looking to protect their livelihood by taking yours. Congress is not the only one on the attack. Other interest groups such as radiology and radiation oncology, pathology and hospital groups have no problem selling you out to protect their interests. There are many fronts to this battle, and there are many groups in the fight.
- Do you want to still be able to use in-office ancillary services such as IMRT and brachytherapy? While actual legislation has not yet been introduced, radiation oncology has already been lobbying hard in Congress to ensure that they are the only ones who should be allowed to perform these services.
Are you concerned now? Good, UROPAC is too. Now is the time for action! UROPAC will do everything we can to prevent legislative actions that will impede your ability to provide high quality care to your patients. But we can’t do it alone!
Support UROPAC today!
During the last election cycle less than 18 percent of all eligible urologists contributed to UROPAC. The average contribution of those 1,500 donors in the last election cycle was only $384.
If every eligible practicing urologist contributed just $500, UROPAC would have more than $4.2 million !
If urology wants to be a respected player in the healthcare debate, urologists, like you, must commit themselves to supporting UROPAC. If you are a donor, thank you for your past support and please contribute again so that UROPAC can continue to fulfill its role advocating for you and your patients on Capitol Hill. If you are not a donor, there’s no better time than now to start!
While we will remain diligent and determined in our efforts, we must be able to counter the resources of those groups that threaten our profession and the interests of our patients. Our opponents do not rest and neither can we. UROPAC’s presence and visibility on Capitol Hill is at an all-time high. With a competitive political environment – especially regarding healthcare legislation – UROPAC needs you to invest in the future of urology. We’ve made tremendous progress, but the future holds many challenges.
UROPAC works on behalf of all urologists, not just a select few, and we ask that you do your part by contributing today. You can’t afford to ignore the effect legislators have on the future of medicine and the effect health policy has on every medical decision you make. UROPAC gives urology a unified voice to speak authoritatively on important legislative and regulatory issues before Congress – something it cannot do without your support.
Again, we implore you to make a contribution today. In these uncertain times, nothing should be taken for granted. Your support of UROPAC can make the difference. Together we can ensure that urology’s voice is heard above the many other groups – not all of whom are friendly to our cause – who are attempting to influence Congress.
Thank you for your commitment to your profession and to your patients. You can make your contribution directly through the UROPAC website.