Advocacy Priorities

Prostate Cancer Screening and Awareness

Eliminating Misdiagnosis and Reducing Wasteful Medicare Spending

Every 20 minutes an American man dies from prostate cancer. The American Cancer Society estimates that 161,360 men were told they have prostate cancer in 2017. Early detection is critical because research shows the five-year survival rate for all men with prostate cancer is nearly 100%.

The current method to diagnose prostate cancer is via needle biopsy of the prostate. Over 800,000 prostate biopsies are performed every year. However, despite the most rigorous protocols for obtaining and handling specimens, about 2.5% are subject to misappropriation or contamination.

This clearly poses an immense issue for the American public. Not only do patients receiving false-negatives lose the opportunity to treat their cancer at its earliest possible stage, but patients receiving false-positives – an estimated 1.3%, according to peer-reviewed literature – are erroneously told they have prostate cancer when they do not. This results in extreme financial and emotional stress, as well as unnecessary, expensive and invasive procedures, including radical prostatectomy and radiation therapy.

Misdiagnosis and subsequent medical expenses can be eliminated through the use of DNA Specimen Provenance Assay, or “DSPA.” This method of testing has evolved over the last several years, and it is recognized as the highest standard of care among prostate biopsy procedures. DSPA matches each patient’s unique genetic profile to that of the diagnostic tissue read by a pathologist or genetic counselor, in order to rule out the presence of undetected provenance complications prior to treatment. This ensures the proper patient is matched to his specimen.

Despite widespread adoption of DSPA as standard of care, the Centers for Medicare & Medicaid Services (CMS) says that DSPA does not fall within a permitted benefit category, and is, therefore, not reimbursed by Medicare. This interpretation poses a tremendous threat to hundreds of thousands of Medicare beneficiaries. To deprive Medicare beneficiaries of access to an important test which eliminates medical errors is contrary to the best interests of patients.

Clinical urologists support efforts to make DSPA testing available to Medicare beneficiaries for prostate biopsies. We urge members of Congress to protect patients from the devastating impact of misdiagnosis by enacting legislation that provides Medicare reimbursement for the simple and cost-saving DNA test that can eradicate medical errors.

Advocacy Priorities
  • Prostate Cancer Screening and Awareness

    Eliminating Misdiagnosis and Reducing Wasteful Medicare SpendingEvery 20 minutes an American man dies from prostate cancer. The American Cancer Society estimates that 161,360 men were told they have prostate cancer in 2017. Early detection is critical because research shows the five-year survival...

  • IPAB Repeal

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  • Graduate Medical Education and Physician Workforce Shortage

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  • The Impact of Pharmacy Benefit Managers on Access to Affordable Treatment

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  • Improve Preventive Task Force Recommendations, Preserve Access to Prostate Cancer Screening

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  • Medical Liability Reform: Protect Physician Volunteers During National Disasters

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  • Modernize Law Restricting Coordinated Care (“Stark Law”)

    When Congress enacted the Medicare Access and CHIP Reauthorization Act, it replaced a fundamentally flawed reimbursement framework with a program promoting value-based care delivery. Value-based care, as measured by the new Merit-Based Incentive Payment System (MIPS) and alternative payment...

  • Patients Over Paperwork: Reducing the Burden of Medicare Red Tape

    Urologists across the country treat a high volume of Medicare patients and therefore deal with the program’s numerous requirements and complex payment structures on a near daily basis. The AACU is dedicated to working with legislators and policymakers to identify ways to simplify and...

State Advocacy
  • Fair Contracting and Medical Practice Freedom

    Where We Stand Ensure openness and fairness in health care provider contacts. Prevent third-party payors from changing the terms of their provider contract without notice to the provider and without the consent of the provider. Ensure that physician licensure is based upon a physician's...

  • Medical Liability Reform — Expert Witness Qualifications

    Strengthen expert witness standards Ensure that expert witness is from the same specialty as the defendant physician Prevent frivolous lawsuits Improve the practice environment for physicians in your stateWhenever a physician’s conduct is being called into question, it is only fair...

  • Prostate Cancer Awareness & Assessment

    Where We Stand Continue the progress that has been made in the reduction of prostate cancer morbidity and mortality with the appropriate use of prostate cancer testing. Ensure that third-party payors provide for the reimbursement of prostate cancer testing when the patient and his physician...

  • Uniform Prior Authorization for Prescriptions and Health Services

    Where We Stand Prior authorizations cost the health system $728 million in 2012. Prior authorization requests must use a single form, no more than two pages in length. Forms must available for both access and submission electronically. Requests are deemed approved if no response is...

  • Work Force — Scope of Practice

    Where We Stand Allow the maximum patient-to-physician ratio to increase based on the number of physician assistants in a practice. Expand the ability of nurse practitioners and physician assistants to supervise medical assistants when doctors aren’t on the premises.Proactive Physician...

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