As the leading voice of independent urology group practices in the US, LUGPA educates policymakers on the benefits of integrated urologic care. Our members drive grassroots efforts by developing thoughtful analysis and engaging public officials through comment letters on major legislative and regulatory proposals.
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Elevate Your Practice: Why LUGPA Advocacy Matters
Discover the tools to shape the future of urology practice! Access our "LUGPA Advocacy: Why it Matters" materials for insights and resources to promote change. Let's amplify our voice and uphold autonomy in urology. You can learn more here.
TAKE ACTION: Members of Congress Need to Hear from You!
When lawmakers hear directly from physicians in their own districts, they listen. At LUGPA, we know that your real-world experience is the most powerful tool in advocacy—putting a human face on the policy issues that affect independent urology every day.
Share your story—your way. Whether through a short video or a written testimonial, your perspective on reimbursement, administrative burden, patient access, workforce challenges, or practice sustainability helps policymakers understand the real impact of their decisions.
Join us in Washington, DC. Attend an in-person LUGPA fly-in and meet directly with lawmakers on Capitol Hill alongside the LUGPA Political Affairs Committee to advocate for independent urology. Contact us if to learn more.
Your voice matters—and it can help shape meaningful change for our practices and our patients.
2026 Legislative Priorities
LUGPA is the leading voice for independent urology practices, dedicated to ensuring patients receive innovative, accessible, and high-quality care. Independent urologists face significant challenges, including stagnant reimbursement rates, rising practice costs, administrative overload, inequities in care delivery, and barriers to accessing advanced therapies.
LUGPA’s 2026 legislative agenda provides a clear, actionable roadmap to address these challenges. These six priorities aim to sustain independent practices, expand patient access, lower costs, and strengthen the healthcare system while fostering innovation and physician wellness.
1. Sustainable Reimbursement and Payment Reform
Medicare Physician Fee Schedule (PFS) & Site-Neutral Reform: Advocate for a permanent, inflation-adjusted PFS tied to the Medicare Economic Index (MEI) to reflect rising staff, equipment, and technology costs. Push for site-neutral payment policies to eliminate disparities, where identical services, such as cystoscopies, may be reimbursed up to 50% more in hospital outpatient departments than in independent practices. These reforms reduce costs, enhance competition, and preserve patient choice.
MACRA/MIPS Modernization: Simplify and refocus the Medicare Access and CHIP Reauthorization Act (MACRA) and Merit-Based Incentive Payment System (MIPS). Current reporting consumes 10–15 hours weekly for many practices. Modernization should streamline metrics to focus on urology-specific outcomes (e.g., prostatectomy recovery) and reward improvements in patient quality of life, rather than generic compliance measures.
Value-Based Care & ASC Expansion: Promote reimbursement models that reward quality and efficiency over volume. Support practices transitioning to value-based care with resources for data analytics and care coordination. Eliminate the Inpatient-Only (IPO) list and expand Ambulatory Surgery Center (ASC) eligibility for procedures such as minimally invasive prostate surgeries, reducing hospital stays and lowering costs by up to 30%.
2. Enhance Patient Access and Care Delivery
Access to Advanced Therapies & In-Office Dispensing: Safeguard access to breakthrough therapies under Medicare Parts B and D, such as immunotherapies for bladder cancer and targeted biologics for prostate cancer. Stabilize drug pricing volatility that disrupts access to treatments costing over $ 10,000 per month. Reinstate in-office dispensing of Part D medications to improve adherence (currently only 50–70% for many urologic drugs) and minimize treatment delays.
Streamlined Prior Authorization & Transparency: Require standardized, electronic prior authorization with 48-hour decision timelines for urgent urologic procedures. Current delays of 7–10 days jeopardize patient outcomes. Promote transparent, public pricing for standard procedures, such as TURP, and strengthen patient education programs to reduce financial toxicity and prevent treatment abandonment.
Encourage Cost-Sharing Reform: LUGPA supports reforms that shift responsibility for collecting patient cost-sharing from physicians to health plan issuers. Policies like this would reduce administrative burden, bad-debt risk, and revenue-cycle complexity for independent practices, allowing physicians to focus on patient care rather than acting as bill collectors. Cost-sharing reform is a practical, provider-focused approach to improving practice sustainability, preserving patient relationships, and countering consolidation pressures without increasing taxpayer spending.
3. Pharmacy Benefit Manager (PBM) and 340B Reform
PBM Transparency & Oversight: Mandate PBMs disclose pricing, rebates, and formulary decision-making to eliminate opaque practices that inflate costs and restrict patient access. Reforms should ensure patients receive affordable, effective medications rather than being forced to switch to less suitable alternatives.
Strengthen 340B Integrity: Refocus the 340B program to serve underserved patients. Enhanced oversight, including audits and eligibility checks, should prevent misuse by large institutions while ensuring independent practices can provide discounted medications (e.g., leuprolide for prostate cancer) to vulnerable populations.
4. Telehealth Permanency and Integration
Permanent Access & Infrastructure Support: Make telehealth access permanent by implementing CMS policies that fund infrastructure and training, particularly in rural communities where 20% of Americans reside but only 10% of urologists practice. Telehealth follow-ups for kidney stone patients, for example, can prevent costly complications while reducing travel burdens.
Fair Telehealth Reimbursement: Guarantee payment parity between virtual and in-person visits, ensuring sustainable adoption, innovation, and equitable access for patients across diverse communities.
5. Workforce Development and Provider Wellness
Address Workforce Shortages: Expand funding to add 50–100 new urology residency slots annually and strengthen loan forgiveness (up to $50,000/year) to recruit physicians into rural and underserved regions. With a projected shortfall of 3,000 urologists by 2030, these incentives are critical to maintaining access to specialized care.
Provider Wellness & Rural Access: Combat burnout, currently affecting 40–50% of urologists, through expanded mental health resources, peer support programs, and flexible scheduling. Invest in mobile clinics and telehealth to deliver urologic care to rural and demographically vulnerable communities, such as Native American populations with high rates of kidney disease.
6. Precision Medicine, Cybersecurity, and AI Innovation
Advancing Precision Medicine: Secure reimbursement for molecular urine PCR testing and germline/somatic genetic testing that enable personalized cancer therapies. For example, BRCA testing informs the use of PARP inhibitors, improving survival rates by 20–30%. Broader coverage will ensure patients benefit from cutting-edge, evidence-based precision care.
Cybersecurity & Ethical AI Integration: Strengthen cybersecurity protections for sensitive health data, such as PSA test results, while enabling secure AI integration in diagnostics, practice management, and patient engagement. Advocate for regulations that support the ethical use of AI, ensuring equitable access to innovations such as AI-assisted prostate biopsy analysis and predictive analytics for cancer recurrence risk.
