JAMESTOWN – Greene County journalist and communications professional Gery Deer joined more than 300 physicians and patient advocates in Washington in February to press federal lawmakers on policies that directly affect access to urological care in Ohio and across the country.

Deer served on one of two Ohio delegations to the 2026 American Urological Association’s Annual Urology Advocacy Summit, held the week of Feb. 22 in Washington, D.C. He represented patients as a member of the Association for the Bladder Exstrophy Community’s Adult Patient Advisory Council.

The summit is designed to bring the voice of the specialty, and the patients it serves, directly to federal lawmakers — creating a bridge between medicine and policy. Over four days, physician and patient advocates receive briefings on pending legislation, reimbursement policy and insurance practices that shape how — and whether — patients can obtain urological treatment.

For communities in Greene County and the broader Miami Valley, those discussions are not abstract. Federal decisions about Medicare reimbursement, prior authorization and insurance oversight often determine how quickly patients can see specialists, whether recommended procedures are approved and how long physicians can continue offering certain services.

The Association for the Bladder Exstrophy Community is a global organization supporting patients and families affected by bladder exstrophy, a congenital urological condition that occurs in about one in every 50,000 births in the United States and worldwide. Deer, owner and creative director of GLD Communications, is one of eight patient advocates serving on the national council and chairs its communications efforts.

The council was formed three years ago by Kimberly Allen and Thomas Vincent of Seattle, both bladder exstrophy patients who saw gaps in long-term support for adults living with the rare condition. Since its founding, the group has developed an adult patient provider list, hosted physician-led webinars and organized patient-centered focus groups.

Participation in the AUA summit allows the organization to connect directly with urologists from around the country and to collaborate on legislation aimed at improving patient care. For Deer, the policy debate over insurance preauthorization stood out as especially urgent.

“Of all the legislation we were discussing with congressional representatives, insurance preauthorization was most important to me,” Deer said. “Bladder exstrophy presents a unique set of lifelong conditions and symptoms that rarely line up with those established within the narrow and often inaccurate coverage guidelines of insurance providers.”

Prior authorization — the requirement that physicians obtain insurer approval before certain treatments or procedures — has become a flashpoint in specialty care. Supporters say it helps control costs and prevent unnecessary procedures. Critics, including many physicians, argue it can delay care and override clinical judgment.

Deer said that during the summit he was surrounded by more than 300 of the nation’s leading urologists. Of those, only about 10 percent have treated or even met a bladder exstrophy patient, underscoring how specialized and rare the condition is.

At an invitation-only insurance roundtable attended by roughly 60 participants, Deer raised concerns about who ultimately decides what care is appropriate. Speaking as a patient advocate, he asked, “If these highly qualified physicians wouldn’t have the skills needed to treat someone like me, how is it remotely possible that an AI program or part time medical advisor would be capable of deciding what treatments are necessary and appropriate?”

He continued: “Urologists willing to treat a bladder exstrophy patient take on a long-term commitment and should have the final say in what treatments are necessary. Insurance companies, however, often disagree.”

For patients in southwestern Ohio, including those treated at major centers such as Cleveland Clinic, those disagreements can translate into delayed surgeries, postponed follow-up appointments or denied procedures. Physicians must devote additional staff time to appeals and documentation, while patients navigate uncertainty about whether recommended care will be covered.

Preauthorization remains a significant barrier in complex, lifelong conditions, Deer said, and he believes the issue extends far beyond rare diagnoses. Patients with cancer, kidney disease and other urological disorders may also face treatment delays tied to insurer review processes.

On Feb. 24, Deer and fellow members of the Ohio delegation met with congressional offices representing their home districts. The group included Dr. Scott Lundy and Dr. Bradley Gill of Cleveland Clinic, along with Hill guide Mykelle Richburg. They met with representatives of Sens. Bernie Moreno and Jon Husted and Reps. Max Miller and Shontel Brown. The office of Rep. Mike Turner declined a meeting.