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This week’s headlines:
Congressional action

Cost to fix Medicare payment formula decreases; lawmakers offer reform proposals
The Congressional Budget Office has reduced the estimated cost for repealing Medicare’s flawed Sustainable Growth Rate (SGR) formula from $243.7 billion to $138.3 billion. This is a significant development as one of the biggest roadblocks to Medicare payment reform has been the estimated cost of repealing the SGR—which just a few years ago exceeded $300 billion.

Over the past two weeks, the American Academy of Dermatology Association (AADA) and other physician groups have met with staff of the House Ways and Means Committee and House Energy and Commerce Committee to discuss a multi-phase proposal to permanently replace the SGR formula. After collecting input from the AADA, other physician organizations, and other stakeholders, the Committees have offered an initial proposal that would replace the SGR and seek to implement a new payment system that would, over several years, phase in payment reforms that include physician-developed measures of quality and efficiency. The House Energy and Commerce Health Subcommittee has scheduled a hearing for Feb. 14 to discuss the SGR and Medicare payment reform. This proposal and others will likely receive considerable attention at the hearing.

In addition, on Wednesday, Reps. Allyson Schwartz (D-Pa.) and Joe Heck (R-Nev.) introduced the Medicare Physician Payment Innovation Act (House Resolution 574), which would repeal the SGR formula. However, the bill does not include recommendations on how to pay for the fix. AADA leadership and staff are closely analyzing these proposals and will be weighing in with these and other policymakers in the coming weeks to support efforts to enact Medicare payment reforms that not only repeal the SGR, but also include reforms that recognize the unique nature of dermatology and dermatologists’ role in providing care to patients. For more information, contact the AADA Government Affairs Department at govtaffairs@aad.org.

Federal agency focus

AADA successfully advocates against onerous Physician Payment Sunshine Act reporting rules
In response to push back from the American Academy of Dermatology Association (AADA) and other organizations, the Centers for Medicare and Medicaid Services (CMS) has removed a burdensome reporting regulation in the final rule on the Physician Payment Sunshine Act. The final rule excludes reporting of pharmaceutical and device industry payments related to accredited continuing medical education (CME) activities that meet the definition of “indirect payments”.

The AADA submitted comments on the proposed rule, urging CMS to rescind this proposed requirement and exclude accredited CME from the reporting requirements, as inclusion would result in significant administrative burdens on accredited CME providers. The final rule outlines further reporting requirements imposed upon manufacturers for payments or transfers of value made to physicians and teaching hospitals. The AADA will continue to analyze the impact of this rule on dermatology practices. Read more about the Sunshine Act final rule, and learn more about the AADA’s advocacy efforts on the Physician Payment Sunshine Act.

HHS releases new HIPAA provisions affecting physician practices
Dermatology practices and other entities must be in compliance with new provisions in the Health Care Portability and Accountability Act (HIPAA) by Sept. 23, 2013. The U.S. Department of Health and Human Services (HHS) has released its final rule updating HIPAA requirements which will go into effect on March 26, 2013.

The rule includes provisions expanding the liability of ‘business associates’ of physicians, hospitals and other HIPAA-covered entities if they leak data in ways that violate patient privacy. Under the HHS definition, ‘business associates’ may include health care data-miners and health information technology service providers.

Additionally, the provisions stipulate that any improper use or disclosure of personal health information is considered a breach that triggers official notification requirements unless the organization in question carries out a risk assessment and determines otherwise.

The rule also establishes new limitations on the use of personal health information for marketing and fundraising purposes; prohibits the sale of a patient's personal health information without specific individual authorization to do so; expands patients' rights to request and receive electronic copies of their personal health information; and broadens patients' ability to restrict, in some instances, disclosure of their personal health information to health insurance plans.

Read more analysis of the final rule on the HIPAA provisions. Read the full text of the final rule.

Call for participation: Accountable Care Organization survey
The American Academy of Dermatology Association (AADA) has been actively working to prepare its members for the impending changes in payment delivery models, particularly with respect to Accountable Care Organizations (ACOs). In an effort to better understand the changing health environment as well as the provider’s perspective regarding participation in an ACO, the AADA requests that members who are currently participating providers within an ACO structure complete a short survey on their experience. For more information on ACOs, visit the Academy’s ACO Resource Center. Email AADA’s Amanda Grimm for more information about the ACO survey.

Deadline to change Medicare participation status Feb. 15
Medicare participation elections and withdrawals must be post-marked on or before Feb. 15, 2013. The Centers for Medicare and Medicaid Services (CMS) announced on Jan. 2, 2013, that they extended the 2013 Annual Participation Enrollment Program deadline from Dec. 31, 2012, to Feb. 15, 2013. The 2013 Annual Participation Enrollment Program allows eligible physicians, practitioners, and suppliers the opportunity to change their Medicare participation status. The effective date for any participation status changes elected by providers during the extension still remains Jan. 1, 2013. Learn more about Medicare participation options and how to change your current status. Email ppm1@aad.org with specific questions.

AADA contacts FDA about new drug shortages
The American Academy of Dermatology Association (AADA) has reached out to the Food and Drug Administration’s (FDA) Drug Shortage Management team regarding several reports from physicians regarding drug shortages among dermatology practices. Products reported as being in short supply include tetracycline, doxycycline, and sodium bicarbonate. The FDA is looking into the shortages and the AADA will provide updates as more information becomes available. Read more about the AADA advocacy efforts to resolve drug shortage issues. Contact AADA’s Amanda Grimm for more information.

2012 EHR meaningful use attestation deadline approaching
Medicare eligible professionals have until Feb. 28, 2013, to register and attest to receive an incentive payment for adopting and using electronic health records (EHR) in calendar year 2012. Qualifying dermatology practices can be reimbursed up to $44,000 for adopting a certified EHR system as long as they have at least $24,000 in Medicare allowed charges per year, and demonstrate their use of the certified EHR in a meaningful way. Read more about Medicare incentives and penalties regarding EHR adoption. Learn more about how to adopt an EHR system, implementing electronic prescribing, and other health information technologies through the American Academy of Dermatology’s online HIT-Kit. Contact Rachna Chaudhari for more information.

Health Canada reviewing safety of acne medication
Diane-35, a medication used for the temporary treatment of severe acne in women, is currently under review by Health Canada. The medication, made by Bayer and licensed in 135 countries, was banned in France last week by France's National Agency for the Safety of Drugs and Health Products, after four women have died of blood clots linked to their use of Diane-35. Although the drug is only approved to treat acne, it is often prescribed "off-label" as an oral contraceptive. Diane-35 has not been approved for licensing by the U.S. Food and Drug Administration. However, physicians may have patients who are taking the drug after purchasing through the Canadian market. For questions, or for more information, contact Amanda Grimm at the American Academy of Dermatology Association.

State policy roundup

Efforts to repeal existing N.D. indoor tanning law fail
North Dakota House Bill (HB) 1188, which would repeal existing statutes on indoor tanning, was voted down in the North Dakota House of Representatives last week and will not move forward. Currently, customers under the age of 14 are not allowed to utilize a tanning device at a tanning facility without a written order from a physician licensed in North Dakota and without being accompanied by a parent or legal guardian. Additionally, HB 1188 proposed a reversal of a statute that requires customers under 18 years old to provide written parental consent to a tanning facility before using a tanning device at that facility.

When the bill was introduced, the AADA sent a letter of opposition to the North Dakota House of Representatives Human Services Committee. Additionally, the North Dakota Medical Association (NDMA) testified on behalf of the NDMA and the AADA at a hearing on the bill. The AADA reached out to the North Dakota chapter of the American Academy of Pediatrics about this issue; the chapter also sent a letter of opposition. For more information, contact AADA’s Lisa Albany.

Seventeen states introduce indoor tanning legislation
The American Academy of Dermatology Association (AADA) has been providing assistance to state societies supporting legislation that would protect minors under 18 from indoor tanning (Alabama, Arizona, Hawaii, Illinois, Indiana, Maine, Maryland, Nebraska, North Carolina, Oklahoma, Texas, Washington); minors under 17 (New Jersey); minors under 15 (Colorado, Virginia); and provide for parental consent (Connecticut, Missouri). Several more states are expected to introduce legislation to strengthen indoor tanning laws this session.

The indoor tanning bill in Hawaii passed out of committee hearing. In New Jersey, the bill passed out of the Senate. In Virginia, the indoor tanning bill passed out of committee and the full Senate. It will now be reviewed in the House. The Virginia hearing was attended by Hazel Konerding, MD. Nebraska is awaiting a vote on its indoor tanning bill, which was heard Jan. 25. AADA and the Nebraska Dermatology Society members David Watts, MD, Mary Finnegan, MD, and Tricia Hultgren, MD, testified on behalf of the bill. For more information, contact AADA’s Kersten Burns.

AADA submits letters supporting truth-in-advertising bills
The American Academy of Dermatology Association (AADA) has sent letters in support of truth-in-advertising bills in Iowa, Nebraska, North Dakota, and Vermont. Iowa House Study Bill 70, Nebraska Legislative Bill 54, and North Dakota Senate Bill 2202 would all require that all advertisements for health care services identify the type of professional license held by the health care professional. In addition, the bills would require that all health care professionals wear a name tag that clearly identifies the type of license held during all patient encounters.

Vermont House Bill 25 would require that all advertisements for health care services identify the type of professional license, certification or registration held by the health care professional. In addition, all health care professionals would be required to wear a photo identification name tag that clearly identifies the type of license, certification, or registration held during all patient encounters.

In its letters of support, the AADA reiterated its position that those who regulate and deliver medical care have an obligation to inform the public of the qualifications and limitations of the persons providing their care prior to treatment. All providers should identify or disclose their degree or field of study, any board-certifications, and licensure to each patient. Read the AADA’s position statement on truth in advertising and professional credential disclosure. For more information, contact AADA’s Lisa Albany.

AADA opposes Virginia biosimilars bill
The American Academy of Dermatology Association (AADA) submitted comments to the Virginia Senate Education and Health Committee opposing Senate Bill (SB) 1285. As proposed, SB 1285 establishes a process for the therapeutic substitution of interchangeable biosimilar medications. However, the AADA argued that the bill fails to put in place important safeguards of physician notification or record keeping. By omitting physician notification and record keeping, the AADA stated that patient safety could be jeopardized. Requiring a notification period to 24 hours prior to the substitution as outlined in the Academy’s position statement could prevent adverse outcomes by requiring the approval of the physician before the medication is dispensed to the patient. After the Committee received the AADA letter, the bill was amended in a hearing to include language that would require record keeping and physician notification within five days of dispensing. For more information, contact AADA’s Kersten Burns.

Melanoma/Skin Cancer Detection and Prevention Month® advocacy resources available
The American Academy of Dermatology Association (AADA) is assisting members and state dermatological societies in promoting May as Melanoma/Skin Cancer Detection and Prevention Month® as a way to establish or enhance relationships with policymakers. State societies and members are encouraged to contact their governors and mayors to seek a proclamation raising awareness about skin disease.

Resources for members to discuss Melanoma/Skin Cancer Detection and Prevention Month® are available online in the AAD Media Relations Toolkit. Members and state societies who are interested in pursuing a mayoral or gubernatorial proclamation can contact Victoria Houghton for assistance.

Advisory Board invites AAD members to submit policy resolutions
As we approach the Annual Meeting, the American Academy of Dermatology’s (AAD) Advisory Board looks forward to hearing the voices of the Academy’s grassroots through the submission of proposed policy resolutions. The AAD Advisory Board invites all AAD members as well as state, local and specialty dermatology groups to submit proposed AAD and American Academy of Dermatology Association (AADA) policy resolutions on issues of interest and/or concern. The Advisory Board convenes every year at the AAD Annual Meeting to deliberate on members’ proposed resolutions, and if approved, propose them to the AAD’s Board of Directors for consideration.

This is the prime opportunity for members to have their voices heard by submitting a resolution from which an official Academy position might arise. The author, or his or her designate, must be present at the AAD 71st Annual Meeting to introduce and discuss the resolution at the Reference Committee Hearing on Friday, March 1, 2013, at 2 p.m. in the Poinciana 1 room at the Loews Miami Beach Hotel. The full Advisory Board will vote on resolutions at the General Business Meeting on Sunday, March 3, at 2:30 p.m. at the Miami Beach Convention Center, room B112/113. All resolutions and questions regarding the Advisory Board should be submitted to AADA staff, Abigail Osborne, at aosborne@aad.org by Monday, Feb. 18, 2013. For questions regarding Advisory Board resolutions, meetings, or general information, contact Abigail Osborne or visit the Advisory Board Portal.

Leadership opportunities

AAD advocacy experts available at AAD Resource Center in Miami
Visit the American Academy of Dermatology Association (AADA) premiere Advocacy booth in the AAD Resource Center at the Annual Meeting to talk with advocacy experts about issues affecting the specialty. From 10:00 a.m. to 5:00 p.m. on March 2 through March 4, AADA staff will be available to answer your questions about the role advocacy plays in providing an influential and trusted voice with key policymakers for your patients, practice, and profession. Talk to experts about private payer issues, regulatory affairs, and state and federal legislative activities. Tell Advocacy staff about important policy issues affecting your patients and practice, and find out how you can become a grassroots leader in your state. The AAD Resource Center is booth 1061 in the Technical Exhibit Hall. Learn more about the American Academy of Dermatology 71st Annual Meeting in Miami Beach, Fla., March 1-5, 2013. Contact Victoria Houghton for more information about the Advocacy booth.

Political affairs – SkinPAC

SkinPAC, Dermatology Advocacy Network to host outdoor reception at 71st Annual Meeting
The American Academy of Dermatology Association’s Political Action Committee, SkinPAC, and the Dermatology Advocacy Network will host an outdoor reception at the American Academy of Dermatology’s 71st Annual Meeting in Miami Beach, Fla. Grab a breath of fresh air with your colleagues on Friday, March 1, at 7 p.m. at the Loews Miami Beach Hotel. The event will be held on the Americana Lawn where attendees can enjoy picturesque views of the Atlantic Ocean, and discuss ways to keep SkinPAC’s momentum and growth going. For more information about SkinPAC and the reception at the Annual Meeting, contact AADA’s Katie Jones at 202-609-6333, or visit www.skinpac.org.

SkinPAC’s political purpose is to solicit and receive contributions to be used to make political campaign expenditures to those candidates for federal elective office, and other federal political committees, who demonstrate understanding and interest in the views and goals of the American Academy of Dermatology Association.


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