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This week’s headlines:
Congressional action

Take action: Preserve patient access to care; funding for life-saving research
The American Academy of Dermatology Association (AADA) calls on all AAD dermatologists to take action and ask Congress to stop the 2 percent cuts to Medicare physician payments that are scheduled for March 1, and call for permanent Medicare physician payment reform. Additionally, important medical research funding at the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention faces the potential of a 5.1 percent cut.

The cuts — implemented through the process known as sequestration — were originally scheduled to occur on Jan. 1 but were delayed two months when the American Taxpayer Relief Act became law on Jan. 3. The across-the-board cuts will not only cut Medicare payments to physicians, but will result in $1.5 billion in cuts to the NIH budget which could lead to 1,380 fewer research grants, a loss of up to 20,500 jobs, and a $3 billion decrease in economic activity. Cancer research funding would also be cut by $250 million.

Join the AADA in advocating for permanent reform that strengthens the Medicare physician payment system and protects Medicare patients. Visit the AADA Dermatology Advocacy Network (DAN) Action Center to learn more about how to get involved, or contact Blake McDonald for more information.

House Energy & Commerce Subcommittee on Health holds hearing on Medicare payment reform
Reinvigorated by recent news from the Congressional Budget Office (CBO) that the estimated cost for repealing Medicare’s sustainable growth rate (SGR) formula has been cut in half from estimates released early last year, lawmakers are moving to find a permanent solution to Medicare physician payment reform.

Last week, the House Energy and Commerce Subcommittee on Health held a hearing to discuss alternatives for the sustainable growth rate (SGR) Medicare physician payment formula. Overall, Subcommittee members agreed that now is the time to take advantage of the lower price tag for the SGR fix and to pass a bipartisan measure that includes input from specialty physicians. Additionally, members expressed an interest in implementing new payment models that enable physicians to choose a payment system that best fits their practice. House Energy and Commerce Committee Chairman Fred Upton (R-Mich.) stated his intent to bring a reform bill to the House chamber for a vote before the August recess.

Over the last 10 years, Congress has taken action 15 times to temporarily avert the cuts required by the SGR, costing a total of $146 billion — funds that could have been used to permanently fix the flawed formula. Last week, the CBO reduced the cost to repeal the SGR formula from $243.7 billion to $138.3 billion. The AADA has consistently reiterated that now is the time for Medicare physician payment reform that repeals the flawed SGR. Learn how you can take action – see related item above. For more information on the hearing, contact Shawn Friesen at sfriesen@aad.org.

AADA advocates for medical research funding on Capitol Hill
On Feb. 13, 2013, the American Academy of Dermatology Association (AADA) joined with One Voice Against Cancer (OVAC) and the Coalition for Health Funding for an advocacy day on Capitol Hill to educate members of Congress and the Senate about the importance of federal funding for medical research, prevention, and health professions programs.

Representing more than 80 national and state organizations and millions of health care providers, patients, survivors, public health professionals, scientists, caretakers, and their families, the two coalitions visited the offices of 75 key members of congressional leadership, House and Senate Appropriations Committees, and newly elected House and Senate members, urging them to take a balanced approach to deficit reduction as Congress faces several budgetary deadlines in the coming weeks, including sequestration, Fiscal Year (FY) 13 Continuing Resolution, and FY 14 Budget Resolution.

The AADA is a member of OVAC, a collaboration of national non-profit organizations advocating for greater federal investment in cancer research, including skin cancer research and prevention. For more information, contact Christine O’Connor at coconnor@aad.org.

Federal agency focus

CMS denies request to halt ICD-10 implementation
The Centers for Medicare and Medicaid Services (CMS) has declined a request from the American Academy of Dermatology Association (AADA), the American Medical Association (AMA) and other medical societies to eliminate the implementation of the new patient diagnosis coding set ICD-10. In December, the AADA signed on to a letter from the American Medical Association (AMA) urging CMS to eliminate the implementation of the new patient diagnosis coding set ICD-10, and delay any mandatory transition until the ICD-11 coding set.

CMS reiterated that there remains sufficient time for providers and the health industry to transition to the ICD-10 codes by October 2014. The AADA will continue to provide member tools to facilitate the transition to ICD-10 and will continue to advocate for ease of implementation. Learn more on how to transition from ICD-9 to ICD-10. For more information, contact Faith McNicholas at fmcnicholas@aad.org.

AADA to attend FDA meeting on drug risk evaluation and mitigation strategies
The American Academy of Dermatology Association (AADA) has been invited to attend a meeting with the U.S. Food and Drug Administration (FDA) to discuss the effectiveness of Risk Evaluation and Mitigation Strategies (REMS), and how to better integrate REMS into the health care system. The FDA requires that drug manufacturers provide REMS for drug or biological products to ensure that the benefits of the product outweigh the risks. The AADA will communicate to the FDA the need to include providers in the development and evaluation of REMS and urge the FDA to make all REMS data public to ensure continued evaluation and improvement to the program. For more information, contact Amanda Grimm at agrimm@aad.org.

FDA issues voluntary survey on iPLEDGE program
As part of the iPLEDGE Risk Evaluation and Mitigation Strategy (REMS), the U.S. Food and Drug Administration (FDA) is requiring the issuance of an annual assessment of isotretinoin prescribers to test their understanding of the iPLEDGE program. Participation in the survey will be voluntary.

iPLEDGE is a Food and Drug Administration-approved, restricted distribution program that is designed to prevent pregnancies in females who are taking isotretinoin and to prevent pregnant females from taking isotretinoin. Learn more about the iPLEDGE program.

This voluntary survey will ask prescribers about the iPLEDGE Program goals and requirements, as well as the safe-use conditions for isotretinoin. Beginning on March 1, prescribers will receive an invitation to take the survey when they attempt to re-activate through the iPLEDGE website. For more information, contact Amanda Grimm at agrimm@aad.org.

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.

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 for 2012 EHR meaningful use attestation Feb. 28
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.

State policy roundup

AADA, DSNJ, ASDSA successfully advocate for New Jersey indoor tanning ban
The state of New Jersey took a positive step toward protecting youth from the dangers of skin cancer. Legislation prohibiting the use of indoor tanning beds by minors under 17 has passed out of both the New Jersey House and Senate. The American Academy of Dermatology Association, the Dermatological Society of New Jersey and the American Society for Dermatologic Surgery Association supported the bill which will now go to Gov. Christopher Christie to sign into law. If Gov. Christie takes no action, the bill will automatically become law and go into effect six months after enactment. For more information, contact Kersten Burns at kburns@aad.org.

Virginia indoor tanning ban bill dies in Committee
A Virginia bill that would protect minors from indoor tanning did not pass out of Committee. The AADA, the American Society for Dermatologic Surgery Association and the Virginia Dermatological Society sent a letter supporting SB 1274 which would prohibit minors under 15 from using indoor tanning devices and require minors who are 15, 16, or 17 to obtain parental consent. The AADA will continue to work with the state dermatology society and state legislature to support a bill that would protect minors from indoor tanning in Virginia. For more information, contact Kersten Burns at kburns@aad.org.

AADA, state societies support biosimilars bills
The American Academy of Dermatology Association (AADA), in partnership with state dermatologic societies, has sent letters of support for biosimilars bills in Colorado, Florida, and Washington. Colorado House Bill (HB) 1121, Florida HB 365, Washington HB 1528, and Washington Senate Bill (SB) 5469 require any pharmacist who dispenses an interchangeable biosimilar to inform the patient prior to dispensing the biosimilar, provide notification of the substitution to the prescriber, and record the brand name or the product name and name of the manufacturer of the biosimilar on the record of dispensing and the prescription label. The AADA worked with the Colorado Dermatologic Society (CDS), the Florida Society of Dermatology & Dermatologic Surgery (FSDDS), and the Washington State Dermatology Association (WSDA) to develop and send letters of support.

The bills largely reflect the AADA’s position on the therapeutic substitution of biosimilar products. The AADA, CDS, FSDDS and WSDA recommended that the bills be amended to shorten the notification from five days to 24 hours prior to dispensing, in order to ensure patient safety. Read the AADA and state society letters of support for HB 1121, HB 365, HB 1528 and SB 5469. To learn more about biosimilars and dermatology review the AADA’s position statement on generic therapeutic and biosimilar substitution and read the August 2012 Dermatology World supplement article on psoriasis biosimilars. For more information, contact Kersten Burns at kburns@aad.org.

Washington state introduces three indoor tanning ban bills; two truth-in-advertising bills
The American Academy of Dermatology Association (AADA), the Washington State Dermatology Association (WSDA), and the American Society for Dermatologic Surgery Association (ASDSA) have sent letters in support of three indoor tanning bills that would protect minors from the dangers of skin cancer. Washington House Bill (HB) 1585, Senate Bill (SB) 5455, and SB 5521 all aim to prohibit minors under the age of 18 from using indoor tanning devices. Read the AADA, WSDA and ASDSA letters of support.

Additionally, the AADA and WSDA also supported two truth-in-advertising bills. HB 1586 and SB 5492 would require that all advertisements for health care services identify the type of professional license, certification or registration held by the health care professional. Read the AADA and WSDA 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 Kersten Burns at kburns@aad.org.

Pennsylvania proposed rule would allow dentists to administer botulinum toxins and dermal fillers
The American Academy of Dermatology Association (AADA) has reached out to the Pennsylvania State Board of Dentistry to express its concerns over a proposed code amendment that would allow dentists to administer cosmetic products including botulinum toxins and dermal fillers. In its letter of opposition, the AADA argued that this proposal would allow dentists to practice medicine, thereby endangering patient safety. Additionally, the rule would not necessitate adequate training required to administer such products.

The AADA will continue to work with the Pennsylvania Academy of Dermatology and Dermatological Surgery, the American Society for Dermatologic Surgery Association, and the Pennsylvania Medical Society to oppose the proposed rule and ensure quality patient care. For more information, contact Lisa Albany at lalbany@aad.org.

AADA opposes Washington bill that would allow master estheticians to perform cosmetic medical procedures
The Washington State Dermatology Association (WSDA), American Society for Dermatologic Surgery Association (ASDSA), and the American Academy of Dermatology Association (AADA) have sent a letter to the Washington State House of Representatives strongly opposing House Bill (HB) 1779 which would allow master estheticians to perform cosmetic medical procedures, such as chemical peels and laser hair removal.

The AADA, WSDA, and ASDSA argued that the practice of cutaneous medicine includes, but is not limited to, performing any act or procedure that, by its intended or improper use, can alter or cause biologic change or damage living tissue. These procedures include the use of all lasers, light sources, microwave energy, electrical impulses, or chemical applications. If enacted, the groups argued, HB 1779 would allow master estheticians to perform these cosmetic medical procedures without the proper medical training and would therefore put patient safety at risk. Read the AADA, WSDA, ASDSA letter of opposition. For more information, contact Lisa Albany at lalbany@aad.org.

Connecticut legislation would repeal tax on cosmetic procedures
The Connecticut Dermatology and Dermatologic Surgery Society (CDS), the American Academy of Dermatology Association (AADA), and the American Society for Dermatologic Surgery Association (ASDSA), are urging the Connecticut Joint Committee on Finance, Revenue, and Bonding to support House Bill 5880 which would repeal the sales tax on cosmetic medical procedures. Current Connecticut law deems “cosmetic medical procedures” as taxable, but exempts “reconstructive surgery” from the tax. Arguing that the distinction between cosmetic and reconstructive is not always clear, the CDS, AADA, and ASDSA reiterated that such a tax not only invades patient privacy and is difficult to administer, but could cost the state more revenue than it generates from the tax. Read the CDS, AADA, ASDSA letter of opposition. For more information, contact Lisa Albany at lalbany@aad.org.

AADA supports Iowa truth-in-advertising bill
The AADA has sent a letter of support for Iowa Senate Study Bill (SSB) 1132 which, if enacted, would require that all advertisements for health care services identify the type of professional license held by the health care professional. In addition, all health care professionals would be required to wear a name tag that clearly identifies the type of license held during all patient encounters. Read the AADA’s letter 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 Kersten Burns at kburns@aad.org.

Six states to hold indoor tanning legislation hearings
Several states have secured hearings for indoor tanning legislation that would protect minors under 18 from the dangers of skin cancer. Bills introduced in Illinois, Maine, North Carolina, Oklahoma, and Washington would prohibit the use of indoor tanning devices by minors under 18. In Montana, minors under 18 would be required to have in-person parental consent in order to use indoor tanning devices. Visit the AADA’s state advocacy Web page to learn more information about the scheduled hearings. Several states have introduced legislation to strengthen indoor tanning laws this session, and are waiting for the bills’ hearings to be scheduled.

The American Academy of Dermatology Association (AADA) has been providing assistance to state societies supporting legislation that would protect minors from the dangers of indoor tanning. Read more about the AADA’s state advocacy efforts. For more information, contact Kersten Burns at kburns@aad.org.

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.

Upcoming events

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 a.m. to 5 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.


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