TALLAHASSEE, Fla. – Today the American Association of Clinical Urologists (AACU), the American Urological Association (AUA) and the Large Urology Group Practice Association (LUGPA) announced support for the USPSTF Transparency and Accountability Act of 2012 (H.R. 5998).
This bipartisan legislation, introduced on June 21 by Reps. Marsha Blackburn (R-TN-7) and John Barrow (D-GA-12), along with Reps. Donna Christensen (D-VI) and Lee Terry (R-NE-2), calls for significant changes to the U.S. Preventive Services Task Force (USPSTF) and the process by which the group makes formal recommendations regarding preventive care services.
Most importantly, the bill strikes language added by the 2010 Patient Protection and Affordable Care Act that directly ties Medicare coverage of a particular preventive service to the grade given by the USPSTF, which is currently comprised primarily of general practitioners without input from specialists on specific diseases.
Other key changes called for by the legislation include a mandate to ensure a “balanced representation of primary and specialty care providers” and other key stakeholders in the healthcare community are involved in development and review of recommendations.
To promote collaboration and enhance the validity of USPSTF recommendations, that panel would be required to:
- Publish a draft research plan (including analytic frameworks, key questions and a literature search strategy as well as methodological guidelines for the project) to guide the systematic evidence review process
- Make the evidence review available for public comment
- Consider findings and research by federal agencies and departments
- Coordinate activity with Federal agencies and departments
- Consult with “external subject matter experts,” including provider and patient advocacy representatives
- Ensure greater transparency in appointing members through a notice and comment process
- Disclose potential conflicts of interest.
H.R. 5998 further establishes a Preventive Services Task Force Board comprised of providers, patient groups and federal agency representatives. This group would provide recommendations to the USPSTF and suggest evidence for consideration when a particular service is proposed for review, and also provide feedback on draft and final recommendations and help disseminate them when finalized.
“Allowing independent bodies to make broad, population-based decisions regarding which tests or diagnostics are appropriate without consultation from the specialists who treat these diseases is inappropriate,” said Rep. Blackburn. “I’m pleased have worked with the AUA to introduce this legislation to ensure that preventive care recommendations are not made in a vacuum. Patients and their physicians have the right to choose which tests are best for them.”
“Over the past few years, USPSTF recommendations on mammography and prostate cancer screening have sent patient communities into a tailspin. Many are confused about what to do and have received mixed messages from their primary care physicians and the community,” said Dr. Dennis Pessis, AUA President. “Decisions about preventive care services – any preventive care service – need to a) take into account feedback from specialists who are experts in these diseases and b) take place in the context of the time-honored doctor-patient relationship.”
“As the providers responsible for the diagnosis and management of prostate cancer – the second leading cause of cancer death in American men – we know these improvements are critical given the recent dangerous and misguided USPSTF issuance of a grade ‘D’ recommendation for PSA-based prostate cancer screening,” said Dr. Deepak A. Kapoor, LUGPA President and Chairman and CEO of Integrated Medical Professionals, PLLC. “This decision was based on faulty analysis of academic literature, ignored important epidemiological data on prostate cancer survival and disregarded the views of clinical experts and patient advocacy groups. These oversights clearly demonstrate the flaws in the existing process and the need for reform.”
“We believe that USPSTF deliberations should be transparent and the panel should be accountable for its recommendations,” said Dr. Arthur E. Tarantino, AACU President. “This bill prevents Medicare from denying coverage for services based on potentially ill-informed USPSTF ratings and opens the process to the scrutiny of the public and experts in the field. The legislation ensures that future recommendations will be clinically appropriate and will keep clinical decision making between patients and their doctors.”
Earlier this week, the American Medical Association’s House of Delegates passed a resolution put forth by the urology community that expresses concern over the USPSTF’s recent recommendations on prostate and breast cancer screening and encourages the USPSTF “to implement procedures that allow for meaningful input on recommendation development from specialists and stakeholders in the topic area under study.”
H.R. 5998 signals official recognition of a policy approved by the American Medical Association’s House of Delegates June 19. Earlier this week, the urologic community secured support from all physicians calling for their national organization to encourage the USPSTF “to implement procedures that allow for meaningful input on recommendation development from specialists and stakeholders in the topic area under study.”
The AACU, the AUA and LUGPA applaud Reps. Blackburn and Barrow, and call upon the balance of the House of Representatives and Senate to speedily join them in their efforts to safeguard patient’s access to care and enhance transparency in the legislative process. Please contact your legislators to voice your support for this bill.
The AACU is the only national organization to serve urology with the sole purpose of promoting and preserving the professional autonomy and financial viability of each of its members. AACU's resources are dedicated to inform members of the issues affecting their practice and profession, and then to work directly to influence the resolutions of these issues. Forty-five percent of all urologists nationwide are members of the AACU.
Founded in 1902 and headquartered near Baltimore, Maryland, the American Urological Association is a leading advocate for the specialty of urology, and has more than 18,000 members throughout the world. The AUA is a premier urologic association, providing invaluable support to the urologic community as it fosters the highest standards of urologic care through education, research and formulation of health policy.
LUGPA represents 95 large urology group practices in the United States, with more than 1,800 physicians who make up more than 20 percent of the nation’s practicing urologists. LUGPA and its member practices are committed to best practices, research, data collection, and benchmarking to promote quality clinical outcomes.
Wendy Waldsachs Isett, AUA