Baltimore, MD, July 16, 2013—Today, the American Urological Association (AUA), a leading advocate for the specialty of urology, released the following response to a new report from the Government Accountability Office (GAO) regarding self-referral and anatomic pathology laboratories, released July 15, 2013. This statement can be attributed to AUA Health Policy Chair Dr. David F. Penson and Dr. Deepak A. Kapoor, President of the Large Urology Group Practice Association.
Urologists are the physicians primarily responsible for diagnosing and treating prostate cancer, the most common non-skin malignancy among American men. As such, we share with the government a desire to ensure high-quality care and appropriate use of healthcare services in treating this common cancer. However, the report released today by the GAO does little to advance a productive discussion around the complex issue of in-office ancillary service utilization, self-referral, and the rising costs of delivering quality care to our patients.
Problems with the report’s design, including the data-gathering methodology used and the analysis of physician self-referral of anatomic pathology services, are significant and were addressed in detail in past comments from both the AUA and the American Gastroenterological Association. It is noteworthy that the U.S. Department of Health & Human Services (HHS), which oversees the Medicare program, did not concur with the GAOs’ recommendations.
Efforts to examine the appropriateness of biopsy procedures should not be limited to self-referring providers. If the Centers for Medicare & Medicaid Services (CMS) were to monitor the appropriateness of anatomic pathology procedures, it should apply to all providers, not just those who self-refer. On that same note, it is of import to note that currently there is no uniform means by which self-referral can be accurately identified. In order to do so, an identifier should be added to future claims.
The GAO’s assertion that urologists and other specialists are utilizing ancillary services for financial gain is both fundamentally wrong and offensive.
To label an entire profession by proposing that urologists are performing unnecessary or inappropriate biopsies to boost their bottom lines not only disparages urologists, but does a great disservice to patients. Urologists should be involved in all aspects of a prostate cancer patient’s care, including referral, diagnosis, and management of the disease. Patient access to in-office ancillary services, including laboratory services, allows for prompt treatment and ensures continuity of care while simultaneously allowing for optimal patient management by the urologist.
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About the American Urological Association: 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 20,000 members throughout the world. The AUA is a premier urologic association, providing invaluable support to the urologic community as it pursues its mission of fostering the highest standards of urologic care through education, research and the formulation of health policy.
Wendy Waldsachs Isett, AUA