AUA Urology Advocacy Summit 2023: Review of Legislative Leave Behind/Congressional “Asks”

( To kick-off the 2023 AUA Summit, Denise Asafu-Adjei, MD, MPH, the 2023 AUA Gallagher Scholar, provided an overview of this year’s main legislative priorities and Congressional “asks” that would be addressed during the Congressional Hill visits.

The first “ask” identified was for Congress to support equitable reforms to the Medicare Physician Fee Schedule (MPFS). Although the Consolidated Appropriations Act of 2023 reduced the degree of reduction in Medicare funding to 2% from 4.5%, the financial implications of this pay cut in the setting of continued strain providing care to patients during and after the COVID-19 public health emergency. Specifically, several urologic procedures face cuts of more than 10% since the MPFS is budget neutral, and Medicare has not updated direct practice expense clinical labor rates.

The next priority focused on expanding and preserving access to telehealth services. During the pandemic, both providers and patients have benefited from temporary flexibilities surrounding the replacement of in-person visits with telehealth services. Urology had a 70% adoption rate of telemedicine since the pandemic began, and led all surgical specialties in utilization. Although the Consolidated Appropriations Act of 2023 did preserve some benefits of telehealth services, the AUA is requesting payment parity with in-office E&M services that were not included in the bill.

Additionally, the AUA provided information regarding a new bill to be co-sponsored by members in both the Senate and the House, the “PSA Screening for Him Act.” In 2023, the incidence of prostate cancer increased for the first time in 20 years, likely as a result of changes to the screening guidelines over the last decade. To help address this troubling trend, the legislation requires private insurers to fully cover preventive prostate cancer screenings that do not have existing coverage under the recommendations of the U.S. Preventive Services Task Force (USPSTF) for men with a family history of prostate cancer, without any cost-sharing or out-of-pocket cost to the patient.

The last “ask” for this Summit was for representatives to cosponsor the Support the Specialty Physicians Advancing Rural Care Act (SPARC Act). This bill aims to alleviate the disparity in access to specialty care, and urology services, in rural communities by providing eligible specialty medicine physicians an opportunity for student loan forgiveness in exchange for practicing in a rural area.

Presented by: Denise Asafu-Adjei, MD, MPH, Assistant Professor of Urology at Loyola University Chicago Stritch School of Medicine, Director of Male Reproductive Medicine

Written by: Ruchika Talwar, MD, Urologic Oncology Fellow, Vanderbilt University Medical Center, @RuchikaTalwarMD during the 2023 AUA Annual Urology Advocacy Summit, Washington, DC, February 27 – March 1, 2023