CUA Members:

The CUA is taking aggressive action on this matter. As motioned in our prior bulletin on this matter back on Nov. 7, 2006, we have been working with the CMA, AMA, AUA, AACU and the other states targeted in order to advise CMS and Congress of this matter. I have already taken this subject up with the AUA board of directors through the Health Policy Council and brought it to the attention of MedPAC, the committee responsible for advising Congress on Medicare related issues.

Some of us are now getting hit hard. Just this week, I have responded to several members individually, spoken with Rick Rutherford of the AUA, arranged to speak with Mike Pretl (AUA legal counsel) and contacted CMA legal department. We are eager for some intervention. Similar battles have been fought in North Carolina, Georgia, Utah, and Oklahoma. While we may have to hire our own attorney, we are hoping to work with CMA legal department since this crosses many specialty lines. We have a strong case that we will prevail on appeal but, in the meantime, urologists it appears will have to refund millions of dollars. Our objective should be to work for an injunction that puts the deadline on hold pending resolution of the issue in general.

I am asking all urologists impacted to notify me on number of patients and dollars to know the scope of our situation. To help us coordinate our efforts, if you have received such a letter or EOB or know someone who has, please summarize your situation and forward information to the CUA. Include the number of patients involved, the dates of service, the amount per claim and total dollars demanded. Please let us know if any of the charts in question had been requested by the RAC for review prior to the demand letter. VERY IMPORTANT, please include the exact date of the first letter or EOB you received that could be construed as a demand for reimbursement. A question of statute of limitations or limits on the scope of work allowed to the RAC may resolve some of these demands.

I will keep you all posted.

Jeffrey Kaufman, M.D.
info@cuanet.org
California Urological Association
1950 Old Tustin Ave.
Santa Ana, CA 92705
PH: 714-550-9155

CLICK HERE to view a copy of Dr. Kaufmans' letter to William Rogers, MD, FACEP, Medical Officer & Director, Physicians Regulatory Issues Team (PRIT), a group of CMS subject matter experts who work to reduce the regulatory burden on physicians who participate with the Medicare program.