On February 27, 2023, hundreds of urologists, residents, medical students, and patient advocates gathered in Washington, DC, to meet with their elected Congress persons and staffers to discuss key policy issues at the AUA Annual Urology Advocacy Summit. I recall my first time at the Advocacy Summit in 2018 as a fourth-year urology resident and then as a recipient of a travel award from the New York section of the AUA. The Summit was by far one of the most impactful meetings of my urological training years and helped to steer my focus on incorporating health policy into urological practice. This year at the AUA Annual Urology Advocacy Summit, I participated in a different capacity—as the 2023 Gallagher Health Policy Scholar.

Four primary policy issues were at the forefront of our discussions with policy makers.

PSA Screening for High-risk Insured Men Act

This proposed legislation would waive cost sharing for prostate cancer screenings in African American men and those who have a family history of prostate cancer. Preventive services with “A” or “B” ratings by the U.S. Preventive Services Task Force do not have cost-sharing requirements under the Affordable Care Act. Prostate cancer screening was upgraded to grade “C” for screening in 2018 for men ages 55-69. Following a similar cost-sharing model for breast cancer screening, this legislation would make it possible for many high-risk men to access preventive prostate cancer services and diagnostics without the financial burden, bringing us closer to equitable prostate cancer care.

Permanent Telehealth Expansion

Urologists have been some of the highest adopters of telehealth in health care, transforming patient care and leading among surgical specialties. Despite the significant benefits this poses for patients requiring urological care, there continues to be disparities in telehealth reimbursements. This year, we advocated for legislation that would make permanent the telehealth benefits extended through 2024 as part of the Consolidated Appropriations Act of 2023 and reimbursement parity. This expansion would preserve access to urological care.

Specialty Physicians Advancing Rural Care (SPARC) Act

We continue to urge Congress members to cosponsor the SPARC Act, which would incentivize urologists and other physicians through loan forgiveness to practice in rural areas with a shortage of specialty physicians. More than 62% of U.S. counties do not have a urologist. The SPARC Act represents a major step toward health equity and access for many Americans given the shortage of primary care and specialty physicians.

Medicare Physician Fee Schedule Reforms

Medicare’s proposed reduction in funding, a result of the Centers for Medicare & Medicaid Services update to direct practice expense clinical labor inputs, severely threatens the ability for urologists to provide patient care. This comes at a time when access to urological care remains a struggle for many patients. A long-term solution to this recurrent reimbursement issue would stabilize physician payments and allow urologists to continue delivering high-quality care.

In summary, the policy issues and priority areas highlighted at the Annual Advocacy Summit center on enhancing access to urological care and achieving health equity. Although the yearly Summit represents a way to unite urologists on the Hill, unity and advocacy on local and state levels are key to effectively pushing these policies forward.