The controversial interim final rule published by the Centers for Medicare & Medicaid Services (CMS) sets up a mandatory payment model surrounding the prices for 50 drugs administered under Medicare Part B, which reimburses providers for drugs administered in a clinic or hospital such as chemotherapy or vaccines. The drug prices are based upon the costs paid by foreign countries. The administration is pushing the rule to lower Medicare drug spending.
“This difference could become greater as the program moves forward. Normally, a drug price doesn’t change too much from quarter to quarter,” said Deepak A. Kapoor, MD. “The quarter-to-quarter variation is going to make it impossible for anyone to … significantly stock this type of drug, which results in a lot of inconveniences to patients because it makes it hard to time their visit,” Kapoor continued. “100% of the burden on this rule is on the providers, which makes colossally no sense.”
Learn more about this controversial interim final rule, by clicking here.
An article that is published in the Journal of American College of Surgeons addressed the issue of how the mounting school loan debt is impacting the choices medical students make in selecting their residency and career specialty. As a guest speaker at Urology Rounds, Deepak A. Kapoor, MD discussed how economics are affecting medical residents. Read Dr. Kapoor’s comments in the Journal of the American College of Surgeons by clicking the link below.
Drs. Latino and Kapoor discussed the importance of organizational preparedness so practices can be ready when the unexpected occurs. Forming a work group team to establish and implement safety and emergency protocols set the foundation for our company to safely continue patient care while protecting doctors and staff. Failing to prepare is preparing to fail. Read the editorial here.
Drs. Kapoor, Latino, Anderson, and colleagues evaluated the impact of safety protocols, including rapid testing and contact tracing, on coronavirus disease 2019 (COVID-19) risk exposure and transmission rates amongst healthcare workers in the outpatient care setting. This study demonstrated the efficacy of initial safety protocols established in response to the COVID-19 pandemic and identified other factors that may impact disease transmission in healthcare workers in the outpatient setting. Click on this link to read the study.
Routine and nonessential healthcare services came to a nearly complete halt in many places throughout the United States as a result of the coronavirus disease 2019 (COVID-19) pandemic. Hospitals and medical practices discontinued or substantially curtailed provision of all but the most necessary procedures. Fearing infection with the novel coronavirus that causes COVID-19, many patients avoided contact with the healthcare system. Caseloads dropped precipitously across physician specialties.
Prior to the pandemic, urologists in the group performed around 1000 prostate biopsies a quarter, said urologist Deepak A. Kapoor, MD, the group’s chairman and chief executive officer. For a few months after the pandemic struck, the number of these biopsies plunged to only a few per week, he said. Dr. Kapoor provides additional insights about how the pandemic impacted urology practices. Read this article to learn more.
Integrated Medical Professionals has been granted a three-year renewal accreditation from the AIUM Ultrasound Practice Accreditation Council in Urology. The Ultrasound Practice Accreditation Council commended Integrated Medical Professionals on its achievement and recognized the efforts taken to provide quality ultrasound.
Healthcare systems and governments in the United States and much of world have had to take unprecedented emergency measures to contain the COVID-19 pandemic. Healthcare providers have replaced office visits with telemedicine encounters and social distancing has become a key component to prevent person-to-person transmission.
While discussing telemedicine visits with Renal & Urology News, Deepak A. Kapoor, MD said “Certainly, we can anticipate that for some patients there will be a great appetite to continue the [telemedicine] services,” Dr. Kapoor said. “Whether we can and will do so depends largely on behavioral changes in the patient population and guidance from regulatory bodies.” To read the entire interview, click on this link.
Epidemiologists and disaster preparedness officials who have contemplated what could spark a public health crisis that overwhelms the nation’s healthcare system and causes widespread social disruption and economic upheaval now have at least one answer: a coronavirus that spreads easily and quickly and can cause severe respiratory distress and death.
Urologists usually are not called upon to contain infectious disease epidemics, but the unprecedented events unfolding since January have prompted them to do their part to contain the spread of the virus.
“For us, it is really about making sure that we’re able to safely keep our doors open and develop strategies to manage the surge [in COVID-19 patients] because the hospitals here are just simply overwhelmed,” Deepak A. Kapoor, MD, chairman and CEO of Integrated Medical Professionals, told Renal & Urology News.
Dr. Kapoor said he has had conversations with administrators at different health systems regarding what his urology group can do to ease the burden on hospitals, such as sharing equipment, staff, and facility space. The mindset is to do “pretty much anything to help. It’s really all hands on deck here.” To read more about the ways that IMP and other urology practices are managing practices and assisting the hospitals, read the story by using this link.
During the current COVID-19 pandemic in the United States, telemedicine services have been expanded through new provisions in the CARES Act. Deepak A. Kapoor, MD and his colleagues at LUGPA discuss how the changes benefit patients and help physician practices. Read the article or watch it on video.
The House passed a $2 trillion COVID-19 emergency bill. Dr. Deepak A. Kapoor and his colleagues at LUGPA discussed the CARES Act, a necessary emergency relief stimulus package and the economic impact the crisis is having on independent medical practitioners. Read the article or watch the video.
At the annual meeting of the Large Urology Group Practice Association (LUGPA) in Chicago, Illinois, Deepak A. Kapoor, MD, Gary Kirsh, MD, John McManus, and Tracy Spicer explored a range of issues impacting health policy during a panel discussion moderated by Richard Harris, MD. The article details a list of wins and setbacks that LUGPA article which can be read below.
LUGPA Health Policy Forum Highlights Wins, Setbacks, and Ongoing Advocacy Struggles
Thomas H. Rechtschaffen, MD, FACS presents information about the possible causes of interstitial cystitis, and management of the condition. Read what he has to say in “Today’s Dietician.”
Deepak A. Kapoor, MD presented “2019 Economic Outlook for Urology in the United States” during the 29th Annual International Prostate Cancer Update on January 26, 2019, in Beaver Creek, Colorado. Dr. Kapoor discussed the history of efforts in the United States to transition healthcare toward a structure of value-based care. He then outlined the major 2019 regulatory initiatives and how they will impact healthcare payments and the administrative burden for urologists. Tune in to hear the valuable information by clicking the link below.
2019 Economic Outlook for Urology in the United States Video
Empire Blue Cross/Blue Shield has agreed to reverse a decision made last month to no longer cover services oncological patients receive from facilities run by Integrated Medical Professionals of Farmingdale. Its 52 locations serviced 1300 Long Islanders, including East Enders who already had to drive up the island to find a facility to receive treatment.
In an interview, Dr. Kapoor said his company didn’t agree to any conditions but rather made Empire understand his company is the most cost-effective road for the HMO to take. “We didn’t take a hit. We are the value provider of services. We have better outcomes at a lower cost,” he said.
To learn more, read the story here.
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.
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.
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.
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 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.
To learn more about what Dr. Kapoor and others think will be changing in radiation oncology reimbursement, read the article here.
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 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.
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 in this article.
Over 174,000 men in the United States will be diagnosed with prostate cancer each year. When treated appropriately, prostate cancer has a high survival rate and may be slow to spread. But even with major advances in treatment options, there are times when the cancer progresses to an advanced stage. “Our goal is to not only extend survival but add quality years, and we are going to work together to make that happen. In the past – even five years ago – we did not have that message of hope,” says Dr. Deepak A. Kapoor. Read this important information about living with prostate cancer.
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 this link.
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.
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.
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 this link.
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 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.
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.
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.
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.
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.
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.
On April 25th, Dr. Riccardo Ricciardi, Jr. (AUCNY-Bayside) was designated a Urolift Center of Excellence. See video from the ceremony here.
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.
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.
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 with all types of urologic issues. To learn more about Dr. Fagelman, please click here.
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.
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.
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.
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 to watch.
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.
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. click here.
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.
Carl A. Olsson, MD and colleagues have been researching gender differences in osteoporosis and fertility, as well as issues of the genitourinary tract (which includes the reproductive organs and the urinary system) during prolonged missions in space. WebMD featured this fascinating interview. Click here to read the results of the study.
Force (USPSTF) were outlined by LUGPA Health Policy Chair Deepak A. Kapoor, MD, during a health policy briefing at the LUGPA annual meeting in Chicago.
Dr. Kapoor outlined LUGPA’s efforts to influence the final rules involving the Quality Payment Program established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), the Medicare physician fee schedule for 2018, and the Hospital Outpatient Prospective Payment System and Ambulatory Surgery Center Payment System.
To read more about the LUGPA Health reform, please click here.
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.
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.
Drs. William Ulmer and Rajiv Saini joined Advanced Urology Centers of New York. Read about them in Long Island Business News.
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, to learn about the advances, click here.
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.
If you need answers about testosterone therapy and want to learn about the associated benefits and risks, read Dr. Kapoor’s interview in the HealthLink section of Newsday. Click here to read the article.
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.
Much has been written about the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Dr. Deepak Kapoor said his group has “stayed ahead of the curve and is actually waiting for the regulations to catch up. We [implemented] protocols and mandatory clinical pathways in 2008, and we audit thousands of charts each month,” he said. Click here to read the interview.
The Sexual Medical Society of North America, Inc. (SMSNA) accepted Dr. Mellinger’s abstract on the complication and post-surgical infection rate in American Medical System’s inflatable penile prosthesis surgeries – a single surgeon study. The abstract was presented at the SMSNA Fall meeting in Scottsdale, AZ and can be seen by clicking here.
Deepak A. Kapoor, MD, Past President of Integrated Medical Foundation (IMF), joined Town of Oyster Bay Councilwoman Rebecca Alesia, IMF Executive Director, Rhonda Samuel and Linda Ottaviano, Executive Director, Greater Long Island Runners Club for a photo promoting the November 2016 Blue Ribbon 5K Run/Walk for prostate cancer at the Syosset-Woodbury Community Park. Advanced Urology Centers of New York (AUCNY) and Advanced Radiation Centers of New York (ARC) are proud to be lead sponsors of this event. To learn about the event, click here.
If urinary tract infections have ever sneaked up on you, and you are looking for treatment answers, you need to read this. Dr. Deepak A. Kapoor dispels myths and provides the “do’s and don’ts” in the December issue of Glamour magazine. Read it here.
In recognition of September as National Prostate Cancer Awareness Month, several organizations joined forces to encourage medical practitioners to speak to their patients about the importance of prostate cancer screenings. “It is important to remember that prostate cancer is not just a men’s health issue, but one that affects anybody with a husband, father, grandfather, brother, son, or friend whose long-term health and wellness could depend upon early detection efforts,” said Dr. Deepak A. Kapoor, President, Advanced Urology Centers of New York. “The evidence is clearer than ever,” continued Dr. Kapoor, “that early detection saves lives.” Learn more here.
Being diagnosed with prostate cancer often feels devastating to patients and their families. But when caught early, today’s advanced and innovative treatments make likelihood that you will make a full recovery better today than at any time in the past.
Read the facts you need to know about prostate cancer treatment from Drs. Deepak Kapoor and Shawn Zimberg in HealthNewsDigest.com.
Featured in Long Island Business News, Dr. Deepak Kapoor discussed a more consumer-focused healthcare. “It has to be easy for patients to communicate with the provider, on the patient’s terms,” says Dr. Kapoor. “If you put up roadblocks, they’re going to choose to do something else.” To read more, click here.