ESWL Reimbursement Slashed By 22%
The 35-day government shutdown over President Trump’s border wall may have had a direct impact on many urologists beyond the many inconveniences and the cost to taxpayers that it caused—a reduction of 22% in the reimbursement rate for a popular procedure. Because of the shutdown, leaders representing urology were unable to meet with officials at the Centers for Medicare & Medicaid Services (CMS) to discuss their concerns regarding the agency’s Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgery Center (ASC) Payment System final rule for 2019.
The rule, which has the effect of slashing reimbursement to ASCs for extracorporeal shock wave lithotripsy (ESWL) by 22%, will make it difficult for many patients in rural communities to gain access to this procedure as they seek treatment for kidney stones, according to the major groups representing urologists. Deepak Kapoor, MD weighed in on the effects of this reimbursement decrease. To read Dr. Kapoor’s comments, click this article.
Exposure to CyberKnife Advertising is Associated with Over-Estimation of Objective Benefits Compared with other Prostate Cancer Treatments
There has been increased direct-to-consumer advertising for Cyberknife (CK), a brand of stereotactic radiotherapy for prostate cancer. Evidence comparing CyberKnife with other prostate cancer therapies is limited. Columbia University Medical Center physicians hypothesized that those viewing CyberKnife advertisements would have inaccurate impressions regarding its effectiveness and safety. In this study, they evaluated impressions of CyberKnife among laypersons exposed to actual advertisements versus factual information/controls. Respondents were more likely to consider CyberKnife superior to other prostate cancer treatments.
Columbia University Medical Center physicians concluded that advertisements regarding CyberKnife are misleading and impact laypersons’ impressions regarding effectiveness and safety. Direct-to-consumer advertising for cancer care is problematic, and relies on the advertiser and surrounding community to ensure accuracy and transparency. To learn more about the details of the study, read it here.
In NYC Subway, CyberKnife Prostate Cancer Ads Mislead
Survey Respondents Influenced by Claims
Direct-to-consumer (DTC) advertising about the radiotherapy (RT) known as CyberKnife (CK), which is currently omnipresent in the New York City transit system, creates “inaccurate impressions” about the treatment’s “comparative effectiveness and safety” in prostate cancer, according to new research.
That conclusion was made by investigators from Columbia University Medical Center after they created an online survey involving 400 men that used language lifted directly from an advertisement. The investigators compared the participants’ responses to the CyberKnife advertisement to responses to information about other prostate cancer treatments. The results may surprise you. Read about the findings here. For more information about the BC/BS decision reversal, read the article here.
Empire Blue Cross/Blue Shield reverses decision to drop LI providers
Last month, the insurer said it was removing Integrated Medical Professionals of Farmingdale, a urology and radiation oncology practice, and Port Jefferson Station-based New York Cancer & Blood Specialists, from its Medicare Advantage HMO and Dual Special Needs Plan networks.
Dr. Deepak Kapoor, Integrated Medical’s chairman and CEO, said “we met with senior staff [at Empire] and it wasn’t at all a difficult conversation. We offer high-quality, lower-cost, value-based care. We were hoping the adults would talk to each other, and that’s what happened. For more information about the BC/BS decision reversal, read the article here.
CMS gives radiation therapy providers a break — but bigger changes may be coming
CMS is letting radiation oncologists bill some E/Ms with superficial radiation therapy (SRT) that had previously been bundled. But those providers should look out: this may be a preliminary step before CMS puts in new regulations that may shake up their reimbursement.
CMS also noted in the fee schedule rule that it had been contemplating adding a new G-code to cover some of the services they had not previously allowed to be billed separately with 77401, including “associated E/M.” Deepak Kapoor, M.D., chairman and CEO of Integrated Medical Professionals (IMP) and past president and current health policy chairman of the Large Urology Group Physicians Association (LUGPA), wonders whether another shoe will soon drop at CMS.
Lawmakers Introduce Bill To Exempt APMs From Stark Law Provisions
A bipartisan group of House lawmakers Wednesday (April 10) reintroduced legislation to give CMS the authority to exempt alternative pay models and those under development from some Stark, or physician self-referral, law provisions, shortly after HHS Deputy Secretary Eric Hargan assured attendees at the American Hospital Association that the department would issue rules as fast as it can easing the Stark and anti-kickback statutes’ restrictions on value-based pay.
Deepak A. Kapoor, MD said that last year’s bill had broad bipartisan, bicameral support, but the clock simply ran out. Read more about this important bill.
Empire Blue Cross/Blue Shield drops another provider from some plans
Empire Blue Cross/BlueBShield said about 7,000 patients of a Farmingdale-based urology and radiation oncology practice have been notified their doctors are being taken out of the network. Dr. Deepak Kapoor says “We have decades of doctor-patient relationships impacted,” and continued “Our hope is we can talk to the insurer and work it out like adults.” Read about how this BC/BS decision will impact patients.
NY Group Rethinks Physician Consolidation to Add Long-Term Value
A group practice in New York is centralizing business operations with their peers to keep practices independent in the face of rapid physician consolidation. Surviving as a small or independent practice in the current healthcare economy is hard. Providers are competing against large, integrated organizations that are just getting bigger. “There are opportunities to streamline and standardize services through some type of central business structure, whether that be an MSO, a statutory merger, IPA, or some other vertical integration,” suggested Deepak Kapoor, MD. Read more about what Dr. Kapoor attributes IMP’s growth to in this article.
Health Insurers Now Cover Prostate Tests
A new law quietly went to effect last month that requires health insurers to cover the cost of routine prostate cancer screening. The new law places prostate-specific antigen screenings on the same level as mammograms. The intent is to encourage more men to take the test, which helps determine prostate cancer risk. New York is the only state in the country to pass this law. “As far as physician practices go, we were in the lead,” said Deepak A. Kapoor, MD. Read Dr. Kapoor’s interview by clicking here.
AUCNY President Promoted to Clinical Professor of Urology at Mount Sinai Hospital
Deepak A. Kapoor, MD, Chairman and Chief Executive Officer of Integrated Medical Professionals (IMP) and President of Advanced Urology Centers of New York (AUCNY), has been promoted to Clinical Professor of Urology at the Icahn School of Medicine at Mount Sinai Hospital. Established in 1852, Mount Sinai Hospital is one of the country’s largest and most highly regarded healthcare teaching hospitals, acclaimed universally for excellence in clinical care and research. Dr. Kapoor was featured in Newsday’s “People on the Move” column.
Organized urology has varied agenda for 2019
As the new Congress, with the House of Representatives now controlled by Democrats, opens up shop this month, physicians—urologists included—will be looking for action on several key initiatives important to their practices and patients. “We’re seeking to update and reform the law to accurately reflect the health care delivery system as it is today,” said Deepak A. Kapoor, MD, chairman of health policy at LUGPA. To learn about the changes, and impact of them, read the interview.
CMS Outpatient Rule Divides Opinion
The Centers for Medicare & Medicaid Services will level payments for outpatient visits regardless of site of service over a 2 year period. There are conflicting opinions about the impact. Dr. Kapoor weighs in during the interview with Urology Times here.
Letter: IMRT ownership study methodology unsound
In a letter to the editor in Urology Times, Deepak A. Kapoor, MD addressed the conclusions of Borza et al on the issue of financial incentives in fee-for-service medicine impacting clinical decision-making (“IMRT ownership appears to influence PCa treatment,” October 2018, p6). To find out why Dr. Kapoor declares the study’s methodology to be unsound, click here.
Histologic Changes in Prostate Cancer Detected Subsequent to the 2012 United States Preventive Services Task Force (USPSTF) Prostate Cancer Screening Recommendation
In 2012, the US Preventive Services Task Force, an independent panel of experts that makes recommendations to the American public, recommended against routine PSA screening for prostate cancer. Since then, there have been a number of studies showing a significant decrease in the incidence of prostate cancer screening as well as the number of prostate cancers diagnosed in the United States. These new studies have discovered that there has been a significant increase in prostate cancer grade and volumes since the USPSTF recommended against prostate cancer screening. Read the research here.
LUGPA backs CMS plan for site-neutral pay for services
Changes in the Medicare fee schedule, including plans to pay essentially the same amount for services whether performed in a hospital provider-based department (PBD) or in individual physician offices, were hailed as “significant wins” in a Health Policy Forum at the 2018 LUGPA annual meeting in Chicago.
The discussion took place a day after the Centers for Medicare & Medicaid Services (CMS) released its final fee schedule rule for 2019. It covered a number of key LUGPA objectives that Deepak A. Kapoor, MD, outlined ahead of the meeting for Urology Times. Dr. Kapoor is LUGPA’s health policy chairman. Read about the new payment system here.
Congress Must Resist Hospitals’ Efforts Against Site-Neutral Payments
Recent efforts by the nation’s hospital industry illustrate the difficulty of controlling expenditures in the nation’s $700 billion Medicare program. Congress included in the Bipartisan Budget Act of 2015 (BBA), a clear, bipartisan message that, to the extent similar services can be safely provided in multiple settings, it is not prudent for Medicare to pay more in one setting compared to another. To read more, click here.
New Treatment Options Reduce Fear Of Advanced Prostate Cancer
Men with prostate cancer often survive 15 years or longer after learning they have the disease, but prostate cancer remains one of the five most common cancers and the second most frequent cause of cancer-related death among men. “This is an exciting time to be in the field of urology,” says Deepak A. Kapoor, MD. “We have a far more robust armamentarium of surgical and medical techniques. We can offer the possibility to extend survival far beyond the 18 to 24 months the patients could historically expect.”
Read more about the newer advanced prostate cancer treatment options that are offering hope, by clicking here.
Gluten-Free Condoms Are Now Available, But Are They Really Necessary?
Organic condom manufacturers claim their condoms are gluten-free. But, um, since when do condoms have gluten to begin with?
If you were concerned that your condoms may contain gluten, Deepak A. Kapoor, MD sets the record straight. Read what he says here
Prostate Cancer Screening recommendations get rolled back by US Task Force
The Us Preventive Services Task Force, an independent panel of experts that makes recommendations to the American public about preventive services updated their previous prostates cancer screening guidelines published in 2012. In 2012, they recommended against routine screening due to the risks involved in additional testing and treatment. Their new position recommends that men between the ages of 55 and 69, particularly those at high-risk for prostate cancer, talk to their physicians about prostate cancer screening. Read the story here.
Dr. Riccardo Ricciardi (AUCNY-Bayside) Designated a UroLift® Center of Excellence
On April 25th, Dr. Riccardo Ricciardi, Jr. (AUCNY-Bayside) was designated a Urolift Center of Excellence. See video from the here.
Bayside Urologist Dr. Riccardo Ricciardi Designated a UroLift® Center of Excellence
Dr. Ricciardi has been designated a Urolift® Center of Excellence. The designation recognizes that Dr. Ricciardi has achieved a high level of training and experience with the UroLift System and demonstrated a commitment to exemplary care for men suffering from symptoms associated with benign prostatic hyperplasia or BPH. To learn more, click here.
Is PTAC on the Right Track? Some Say ‘No’
-Physician groups express frustration with HHS payment advisory committee
In July 2017, the Large Urology Group Practice Association (LUGPA) submitted a proposal to PTAC. The “LUGPA APM for Initial Therapy of Newly Diagnosed Patients with Organ-Confined Prostate Cancer” proposed incentivizing urologists to choose “active surveillance” as a method for treating certain cancer patients when “clinically appropriate.”
In December 2017, PTAC voted not to recommend the LUGPA APM
In other words, doctors shouldn’t be paid for doing what they should, the committee seemed to argue. LUGPA President Deepak Kapoor, MD, said he was frustrated that even though PTAC agreed that the LUGPA model met many of the high-priority criteria, they remained “philosophically” opposed to the model. Click here to read about the frustrations that some physician group practices are expressing.
Prostate Cancer Awareness Campaign Viewed on NASDAQ Tower
New urologist at Advanced Urology Centers New York’s (AUCNY) Rockland location
Dr. Elliot Fagelman of Stony Point, is the newest urologist to join Advanced Urology Centers of New York’s (AUCNY) Rockland County office in West Nyack. Dr. Fagelman, a board certified physician, has extensive experience treating patients for all types of urologic issues. To learn more about Dr. Fagelman, please click here.
How One Specialist’s Advanced Alternative Payment Model Can Serve as a Framework For Value-Based Care
A urologist built an APM because the specialty of urology was left wanting when it comes to APM options. Deepak A. Kapoor, MD decided the best way to speed urology’s pivot to value-based care was to create an APM from scratch. To learn about this model, click here.
Bill Would Lift Stark Barriers to APMs
New legislation to modify the Stark antitrust law to remove barriers to independent physicians has been introduced. Deepak A. Kapoor, MD told Urology Times that the “30-year-old Stark Law self-referral prohibitions effectively block coordination of care by physicians. Stark was designed for fee-for-service, not value-based care.” To read the article, click here.
Proposed Bill Targets Prostate Cancer Misdiagnoses
Legislation would authorize CMS to pay for backup DNA tests
Deepak A. Kapoor, MD, chairman and CEO, Integrated Medical Professionals, Melville, NY, told the Energy and Commerce Committee that a 2015 study found that misdiagnoses based on needle biopsies occurred in 2.5% of cases and would largely be eliminated if the backup DNA test became standard practice (J Urol 2015; 193:1170-7). The study concluded that at least 1.28% of those patients were actually cancer free.
Dr. Kapoor is health policy chair at LUGPA, which along with the AUA, the Men’s Health Network, the Prostate Health Education Network, and several other related groups have endorsed the legislation. Read about the bill and how it benefits patients here.
AUCNY Doctors Defend LUGPA APM
Did you watch Dr. Deepak A. Kapoor and Dr. Kathleen Latino defending the LUGPA APM proposal to the full PTAC committee? If you missed it, click here.
John Rescigno, MD Joins Advanced Radiation Centers of New York in West Nyack
John Rescigno, MD, from Manhattan, recently joined Advanced Radiation Centers of New York (ARC). Dr. Rescigno is providing patient care at the Advanced Radiation Centers [ARC] West Nyack office. Learn about him by clicking here.
ARC Docs Provide Cutting-Edge Radiation Treatment at Good Samaritan Hospital
Thanks to the addition of a cutting-edge radiotherapy treatment, patients at Good Samaritan Hospital now have access to one of the newest tools in the fight against cancer, the TrueBeam Linear Accelerator system. Dr. Shawn Zimberg, medical director, Dr. John Rescigno, associate medical director, and Dr. Raman Kaul currently treat patients at Good Samaritan Hospital using the hospital’s new system. To read more, click here.
Dr. Alexander Epelbaum Appointed President of Medical Staff at St. Catherine of Siena
Dr. Alexander Epelbaum of Dix Hills, a urologist at Advanced Urology Centers of New York in Smithtown, has been appointed president of the medical staff at St. Catherine of Siena Medical Center in Smithtown. See the Newsday article here.
A Bill to ‘Eliminate Prostate Cancer Misdiagnosis’
More than 1 million prostate biopsies are performed in the U.S. each year. Provenance errors (i.e. switching and contamination) in prostate cancer diagnosis occurs at a rate of 1.28%. Deepak A. Kapoor, MD and colleagues feel that the DNA test ensures that a prostate cancer diagnosis is given to the correct person. The DNA test “definitely rules out” these errors, said Dr. Kapoor. To read more about the value of DNA tests, click here.
Incentivizing the Lower-Cost Decision: LUGPA Believes It Knows How
A newly proposed urology-specific alternative payment model (APM) could save up to 37% on costs of care, partly by giving physicians incentives to pursue active surveillance (AS) rather than active intervention (AI), according to the Large Urology Group Practice Association (LUGPA). To read about the model, click here.
Riccardo Ricciardi, MD accepted prostate cancer awareness proclamation
In recognition of the efforts in the fight against prostate cancer, Queens Borough President Melinda Katz presented Riccardo Ricciardi, MD of AUCNY Bayside with a prostate cancer proclamation and declared October 19th prostate cancer awareness day in Queens. Click here to see the article.
Stay Clinicians Embrace New Prostate Cancer Grading System
October 2017- First described in a paper published 4 years ago, the new Gleason grade group system for the risk classification of prostate cancer (PCa) is now routinely included in PCa pathology reports and commonly used in counseling patients newly diagnosed with the malignancy. Dr. Elliot Paul shares his thoughts about the new system. Click here to read about it.
Advanced Urology Centers of New York Adds Two New Doctors
October 2017- Drs. William Ulmer and Rajiv Saini joined Advanced Urology Centers of New York. Read about them in Long Island Business News.
Stay Vigilant About Prostate Cancer
September 2017- We know how important it is to be screened for prostate cancer. Early detection saves lives. More than 3 million men and their families are fighting the disease today. Deepak A. Kapoor, MD and an Advanced Urology Centers of New York patient discuss progress in prostate cancer treatments. If you didn’t read the story in the Anton Media newspapers, click here to learn about the advances.
Learn About our Services in Our New ARC TV Spot
September 2017- Did you see the new ARC commercial airing on Cablevision, Comcast and Verizon Fios? If not, learn about our services and meet some of our physicians and staff here.
Nicole Fleischmann, MD Shares the Benefits of Interstim on WCBS-TV
September 1, 2017, If you find yourself looking for bathrooms wherever you go, you’ll really want to watch Dr. Fleischmann’s interview with Dr. Max Gomez. She provides a valuable solution to overactive bladder.
Michael Ziegelbaum, MD, FACS Appointed President of LIJ Hospital Staff
Deepak A. Kapoor, MD Testifies to the House Energy and Commerce Committee
August 2017- The diagnosis of prostate cancer is usually established with a test called needle biopsy of the prostate. Doctors rely on the results of the biopsy to counsel patients about the treatment options available to them. “Precision medicine and targeted therapy requires complete and total diagnostic accuracy in this test,” says Dr. Kapoor. Despite best laboratory practices, errors are being made. Click below to hear the testimony. https://youtu.be/ljq65riJiWY
Do you Plan Your Day Around Being Near a Bathroom?
August 2017- Visit an AUCNY physician and get back in control of your life! https://youtu.be/Mt2xi-0A0P4
Suozzi Subject of “Probe”
August 2017- Congressman Tom Suozzi underwent a routine prostate exam as part of an effort to raise awareness about prostate cancer and the importance of getting checked. The screening was administered by Integrated Medical Foundation (IMF), a non-profit organization which promotes awareness and early detection of prostate cancer. It entailed a PSA blood test and a digital rectal exam administered by IMF Founding President Dr. Deepak Kapoor, M.D. of Advanced Urology Centers of New York. Read about the results here.
Sid Rosenberg of WABC radio’s “Sid & Bernie” Show talks about ARC
January 2017- Did you hear Sid Rosenberg of WABC radio’s “Sid& Bernie” show talk about ARC? If not, tune in to listen.
Sid Rosenberg of WABC radio’s “Sid & Bernie” Show talks about AUCNY
January 2017- Did you hear Sid Rosenberg of WABC radio’s “Sid & Bernie” show talk about AUCNY? If not, tune in to listen.
Origins of the U.S. Preventive Services Task Force
January 2017- Dr. David Crawford invited Dr. Deepak Kapoor to discuss the origins and background of the U.S. Preventive Services Task Force (USPSTF). This presentation is especially timely and important with the USPSTF’s recommendation against prostate-specific antigen (PSA)-based screening for prostate cancer. Listen here.
LHRH Agonists and Antagonists in Prostate Cancer
January 2017- Carl Olsson, MD, compared the efficacy of LHRH agonists with antagonists, which are commonly used to treat patients with prostate cancer. Tune in here.
Weighted Gleason Grade Group: A New Prostate Cancer Biopsy Reporting System with Prognostic Potential
December 2016- Drs. Carl A. Olsson and Deepak A. Kapoor teamed with colleagues from world-renowned institutions to propose a new prostate cancer biopsy reporting system which has prognostic potential. To see the poster presented at the 2016 Society of Urologic Oncology (SUO) Annual meeting, click here.
Adapting to the New Value-Based Payment Models
December 2016 Deepak A. Kapoor, MD discussed how physicians can adapt to the new value-based payment models. To listen to the interview, click here.
Dr. Nicole Fleischmann Takes the Questions out of many Female Health Issues
November 2016- Nicole Fleischmann, MD had a candid conversation about women’s issues with Lisa Davis of “It’s Your Health.” She discussed different diagnoses and the exciting new MonaLisa Touch® treatment. Click here to get answers to many of your questions.
- Learn About our Services in Our New ARC TV Spot
- Nicole Fleischmann, MD Shares the Benefits of Interstim on WCBS-TV
- Michael Ziegelbaum, MD, FACS Appointed President of LIJ Hospital Staff
- Deepak A. Kapoor, MD Testifies to the House Energy and Commerce Committee
- Do you Plan Your Day Around Being Near a Bathroom?
- Suozzi Subject of “Probe”
- Sid Rosenberg of WABC radio’s “Sid & Bernie” Show talks about ARC
- Sid Rosenberg of WABC radio’s “Sid & Bernie” Show talks about AUCNY
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