CUA 2008 ACTIVITIES & ACCOMPLISHMENTS • We successfully had the new national RAC program substantially altered (although not killed) based on our complaints and recommendations from last year. Additionally, the RAC contractor used in California last year was NOT awarded a new contract, partially based on our poor experience with them. Finally, although the law indicated that a new RAC contractor would start this past October in California, in fact, none has begun nor is one scheduled until much later in the program (before 2010) because of our input. • We successfully partnered with Palmetto, the new MAC carrier for CMS on rewriting the protocol for cryosurgery on renal masses after their changeover. We also helped many, many state urologists iron out payment problems with Palmetto due to the dual challenge of changing to NPI identifiers and transitioning from NHIC to Palmetto as the state carrier. • The state was well represented in Washington this year as we lobbied to revise the intended 16% cut in SGR payments from Medicare. We were successful in reversing the intended cut, maintaining a 0.5% increase for 2008 and another 1.1% increase beginning 1/1/09. However, there is still much work to be done to prevent a deep cut of 21-23% on 1/1/10 if the SGR formula is not finally revised. • At the same time, the CUA was well represented as we lobbied Washington to mitigate the new Stark III rules and final rulings from CMS regarding ESWL and other partnerships. Although the new rules impact many practices, they would have been much worse absent our advocacy for members. • We were also successful beating back attempts by radiology at the state level to restrict and regulate urologists' performance of imaging studies including ultrasound. Unfortunately, the challenge persists and we must remain active to maintain our rights to provide all appropriate services to our patients. • The CUA sent delegates to represent our member’s interests to the following:   o California Medical Association Specialty Delegation Meeting.   o California Medical Association Committee on Legislation.   o The California Technology Assessment Forum (we were asked to formulate positions on Robotic Assisted Surgery for Radical Prostatectomy and the Renessa non-surgical Radiofrequency Treatment for Stress Urinary Incontinence.   o The AUA Joint Advocacy Conference in Washington D.C. • Maintain ongoing consultations with Greg Smith, attorney and expert on enhancing ancillary fee revenues for urology practices. Greg also advises CUA on federal health care compliance, including Stark and Anti-kickback rules, and state health care compliance issues, malpractice planning, regulatory compliance, contracting, anti-kickback, physician self-referral laws and tax planning. • Assisted numerous member requests on an assortment of issues such as RAC audits, unfair reimbursement and coding practices, practice management questions, etc. • Sent out 10 special bulletins and alerts to assist members with time sensitive issues • Co-produced with Western Section AUA the 2008 Health Policy Forum in Monterey, CA including 3 practice management courses that together provided 5 hours of CME. • Held annual meeting in Monterey, CA (during Western Section AUA annual meeting) in which over 120 urologists were present. The featured speaker, Dr. Mark Moyad, spoke on “Promoting Wellness for Your Prostate Cancer Patients.” • Held Interim Board Meeting in Orlando, FL during AUA in which 10 members were present.