Featured News Archive

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Congress Repeals 3% Tax Withholding Statute

AACU Past President Herb Sohn, MD, played a significant role in securing Congressional approval of a measure to repeal a planned 3% tax-withholding that may have impacted Medicare payments to physicians. H.R. 674 repeals a 2006 statute that would have required 3% of all government payments to be withheld in order to increase tax compliance. The original statute was overly broad and would have applied even to Medicare payments made to physicians. The cost of this repeal was offset by a change in the definition of Medicare Adjusted Gross Income for the calculation of eligibility for Medicaid or insurance subsidies under the Affordable Care Act.

AACU State Advocacy Conference Informs, Engages

The AACU convened a record number of urologists, including more than 20 presidents of urology state societies, to promote engagement in state-level advocacy and public policy. The fourth annual conference proved to be the most successful to date, not only in the number of attendees, but also the quality and maturity of the program.

AACU State Society Network Advocacy Conference chair Mark S. Austenfeld, MD, and co-Chair Arthur Tarantino, MD, invited highly-regarded physicians and experts to speak on state-level implementation of federal health care reform, the role of non-physician providers in urologic practice, legal challenges to medical liability reform and effective legislative advocacy. Participants also took home recommendations on fundraising for on-the-ground surveillance of government activity and engagement of patients and industry partners in mutually beneficial advocacy campaigns.

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AACU Elects 2011-2012 Board of Directors, Honors Service of Sushil Lacy, MD

The 2011-2012 AACU Board of Directors will be led by President Arthur Edgar Tarantino, MD. During an annual business meeting held in conjunction with the AACU State Society Network Advocacy Conference, members elected Mark S. Austenfeld, MD, to serve as President-Elect, while Jeffrey M. Frankel, MD, and Richard S. Pelman, MD, were selected to take on the roles of Historian and State Society Network Chair, respectively. The AACU also honored the service of outgoing Historian and past-President Sushil Lacy, MD.

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House Energy & Commerce Committee Passes Medical Malpractice Reform

Yesterday, the Energy and Commerce Committee reported HR 5, The HEALTH Act, by a vote of 30-20 along party lines.

H.R. 5 would limit noneconomic damages in medical malpractice awards to $250,000. It also would limit punitive damages in medical malpractice awards to twice the economic damages or $250,000, whichever is greater.

Twenty-eight states have already enacted medical liability reform that includes caps on non-economic damages. The HEALTH Act is modeled on these successful state laws, protecting patients' rights while curbing junk lawsuits that drive up costs for everyone.

According to the Congressional Budget Office (CBO), medical liability reforms, such as those included in H.R. 5, would reduce the federal deficit by $62 billion.

Details of The HEALTH Act

• Ensures plaintiffs can recover full economic losses, but limits non-economic damages to $250,000.  H.R. 5 establishes a fair share rule that apportions damages based on a defendant’s degree of fault. 
• Establishes a sliding scale for attorney contingency fees to ensure patients can access legal representation without forfeiting an exorbitant share of the damages they are awarded to trial lawyers.
• Allows evidence of collateral source benefits to be introduced to prevent double recovery, which is when a plaintiff has already had medical expenses covered (by, for example, an insurance plan or through Medicare or Medicaid) and is awarded those same costs in a trial.
• Sets standards for the award of punitive damages, including a limit on the amount of punitive damages to two times the amount of economic damages awarded or $250,000, whichever is greater.  Punitive damages are not intended to compensate the injured party but rather punish malicious behavior.  H.R. 5 would limit punitive damages to instances where a person acted with malicious intent or deliberately failed to avoid injury that was substantially certain to occur.
• Allows courts to require periodic payments of damage awards.

AACU Endorses the Medicare Decisions Accountability Act of 2011

The American Association of Clinical Urologists (AACU) once again would like to thank Congressman, and physician, Phil Roe (R-TN) for introducing HR 452, The Medicare Decisions Accountability Act. 

This legislation will eliminate the highly contested Independent Payment Advisory Board (IPAB).  Eliminating the IPAB has been one of AACU’s number one legislative agenda items since before it was enacted in the Patient Protection and Affordable Care Act (PPACA).

Please click here to read AACU’s letter to Congressman Roe.

Feel free to contact the AACU at info@aacuweb.org or call 847.517.1050 if you have any questions or would like additional information on this matter. 

New Stark Disclosure Rule Goes Into Effect

Revisions to the Stark Law went into effect on January 1, 2011.  Section 6003 of the Patient Protection and Affordable Care Act (PPACA) adds a requirement that physicians who furnish MRI, CT or PET services for their Medicare patients inform the patient in writing at the time of the referral that the patient may obtain the MRI, CT or PET test from another provider.  The physician is also required to provide a written list of suppliers who furnish those services in the area where the patient resides.

The final rule, released in November, includes a number of changes over proposed rules shared in June.  The change brings down the number of alternative suppliers suggested from 10 to five, and it does away with the need to obtain a patient's signature on the disclosure form or to save it in the patient's medical file.

The rule does allow an exception for providers practicing in areas where less than 5 suppliers are located within a 25 mile radius.  Those providers should list all of the suppliers within the area.  Hospitals are not considered suppliers, but may also be listed

As always, AACU will keep its membership informed of any new information that comes about.  If you have any questions regarding this, or any other issue, please contact us at info@aacuweb.org.

AACU Responds to Journal of Urology Article

The American Association of Clinical Urologists has responded to the recently published article, "Imaging Use Among Employed and Self-Employed Urologists" in the Journal of Urology.

AACU felt the article attempted to directly link increased imaging use to urologists who are self-employed. The AACU leadership felt this article attacked the character and motivations of practicing urologists.

Please click here to read a copy of AACU's Letter to the Editor

For more information on this issue, please visit our website or contact us at info@aacuweb.org.

Update on Least Costly Alternative

On December 22, 2009 the United States Court of Appeals (District of Columbia Circuit) upheld the lower court decision in the case Hayes v. Sebelius. The case was heard on appeal from the United States District Court. The District Court had ruled that the defendants’ are permanently enjoined from implementing or enforcing the April 2008 local coverage determinations for DuoNeb or any local coverage determination for DuoNeb that bases reimbursement on a least costly alternative standard.

To read the court documents please click below:  

[DC Circuit Judgment]
[DC Circuit Decision]

CMS did not appeal the U.S. Court of Appeals decision to the Supreme Court of the United States and in fact issued a Joint Signature Memorandum ( JSM- 10239) dated April 19, 2010 directing all Medicare contractors to immediately cease the application of all LCA provisions in existing LHRH Local Coverage Decisions (LCDs).

• CMS stance prior to the appeals court decision was that LCA was a local carrier decision. This is no longer the case based on the above mentioned JSM issued by CMS.
• All Medicare contractors have complied with the CMS mandate to eliminate the application of LCA policies with regard to Part B drugs.

Some notable excerpts from the U.S. Court of Appeals opinion include;

• “Nothing in the statute authorizes the least costly alternative policy”.
• “Our conclusion finds support elsewhere in the Medicare Act, specifically its mandatory reimbursement formulas……For drugs, the amount of payment is 106% of the average sales price, as determined under the statutory formula”.