2000 – 2001 Accomplishments

President visited local component Urological societies to find out the issues and concerns for their region and also met with state specialty societies to discuss common concerns, such as CLIA, EMTALA problems relative to ER coverage and class action lawsuits.

President met with CMA leaders to lobby Sacramento for more money and fewer regulations. Attended Medicare Advisory Committee meetings, Sacramento political rallies to communicate impact of political and economic entities to improve conditions on a state and local level.

COL representative put forth legislative efforts and plans in Sacramento to lobby for laws that enhance ability to practice with reasonable reimbursement and regulatory relief and protection as well as increases in MediCal rates.

CUA Carrier Advisory Committee Co-Chairman Martin Ross, M.D. sought reimbursement for prostate therapies such as TUNA, TUMT and Laser prostatectomy

Communicated to California Senators on behalf of CUA to oppose “user fees” on Medicare providers included in Bush’s proposed fiscal year 2-002 budget for the Department of health and Human Services.

Notified urologists to write to Blue Shield and demand a redress from the Blue Shield negotiators who denied payment for one of the Ultrasound codes bundling it to the other.

CUA Carrier Advisory Committee works to establish good relations with regional medical directors. CUA Member Martin Ross, M.D., Torrance, elected co-chairman of the Medicare Carrier’s Advisory Committee.

Addressed the Medical Board of California about the “Legal Scope of Practice from Medical Assistants” in its Legal Handbook which denies non-RN medical assistants the privilege of putting in catheters. Pursing issue on behalf of urologists.

NHIC asked CUA to develop a policy on Water Induced Therapy and to take the lead in coordinating policies nationally for the competing technologies and will be submitted to the AUA for use throughout the country.

Engaged key speakers Dr. Frank Staggers, president of the CMA and Dr. Arthur Lurvey, medical director for NHIC to address the membership at the annual business meeting in Anchorage.

Informed members about new HIPAA Regulations that will alter office practices.

1999 – 2000 Accomplishments

Presented "Medicare and the Practice of Urology"
program during CUA Annual Meeting with
the Medical Directors of Southern and Northern California Medicare

Held first-ever face to face discussion
with medical directors from NHIC and TOLIC to better understand dynamics
behind Medicare policy decision.

CUA Carrier Advisory Committee establishes good relations
with regional medical directors. CUA Member Martin Ross, M.D., Torrance, elected co-chairman
of the Medicare Carrier’s Advisory Committee.

Worked with CMA regarding support for MICRA, enhancing opportunities
for collective bargaining (such as Campbell HR1304), H MO responsibility and reliability,
state funding for MediCal and CCS and input on issues micromanaged by Sacramento.

Ongoing and effective representation on the CMA’s Commission on Legislation.

Obtained CMA Lobbyist Steven Thompson for key note speaker to discuss
New Forces of Managed Care in the New Millennium.

CUA effectively influences Medicare to revoke the HCFA regulation
limiting payment for GNRH analogs (like Lupron) and to make restitution on
hefty underpaid and unpaid fees for urologists offices.

Initiates and helps implement the Urology Practice Administrators,
a new category of AUA membership, to help urologists offices
with the advent of managed care issues.

Mailed custom-designed membership certificates to all members.

1998 ISSUES AND ACCOMPLISHMENTS

Successfully lobbied before Northern and Southern California
Medicare Carriers to provide reimbursement for
office visits and medications for Caverject injection
therapy and patient instruction.

Successfully lobbied before Northern and Southern California
Medicare Carriers to prevent incorporating payment
for abdominal, pelvic and/or bladder ultrasounds into the
E & M visit. They will continue to be paid separately.

Lobbied before Northern and Southern California Medicare Carriers
to make treatment with TUNA for BPH a reimbursable
procedure. (ongoing issue).

Successfully lobbied before Northern and Southern California
Medicare Carriers to have treatment with Microwave
(trans-urethral microwave thermotherapy) for BPH a
reimbursable procedure.

Successfully lobbied Blue Shield of California to reverse a decision
to bundle trans-rectal ultrasound of prostate, ultrasound
guidance for prostate biopsy, and prostate biopsy
refusing to pay for each procedure. They will now pay
appropriately and reconsider resubmission's for previous
denials.

Lobbied before Blue Shield technical advisory committee to have
cryosurgery for prostate cancer approved as a
reimbursable procedure.

1995 - 1997 Accomplishments and Ongoing Projects

 

Managed Care Publications:
1997 Monographs in Urology
Development of Mission Statement
House of Delegates
1997 Resolution brought to CMA
Board of Directors
Sound Financial Situation
Liaison With Physician Reimbursement Systems to provide coding tips

Legislative Activities:
Successful legislative efforts on SBHR 3103-Health Insurance Reform Act of 1996
CUA support of US Surgeon General Candidate
CUA support of Americans For Responsible Reform "Painter v. Shalala and the Department of Health and Human Services"

CUA Office:
Computer systems upgrade
Development of CUA's Web Site
E-mail Communications: Leadership Accessibility
Liaison With Other Groups:
CMA - Cooperation on legislative efforts and support of California Advantage
SUC - Assisted with representing cryosurgeons at Blue Cross/Blue Shield Meeting,
Supported efforts to obtain state reimbursement for cryoablation of the prostate
ALS - Joint Meeting and Fund Raising Program for "Managed Care 2002"
AUA and AACU - CUA members are active on AUA & AACU committees
CMA Specialty Delegation - Represented CUA at monthly meetings

Educational Programs
Presentation of "Managed Care - 2002" Beyond Capitation, March 8, 1997
in La Jolla and on July 31, 1997 in San Diego

 
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