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This week’s headlines:
Congressional action

House Energy and Commerce Committee passes bill to repeal IPAB
On March 6, the House Energy and Commerce Committee passed HR 452, legislation to repeal the Independent Payment Advisory Board (IPAB) that was created as part of the 2010 health system reform law. The inclusion of the IPAB is the primary reason that the AADA opposed the reform bill due to the removal of congressional oversight of Medicare policy, the lack of IPAB’s accountability to Medicare beneficiaries, and the establishment of another flawed system based on an expenditure target. The AADA has sent a letter to congressional leadership urging swift action by the full House of Representatives. You can personally tell you members of Congress to repeal the IPAB by sending them an email via the DAN website.

FDA publicly commits to determine tanning bed classification this year
After the AADA communicated concerns regarding the lack of progress on the FDA’s consideration of reclassification of indoor tanning beds, Rep. Rosa DeLauro (D-Conn.) questioned FDA Commissioner Margaret Hamburg, MD, on this issue during a congressional hearing on Feb 29. Rep. DeLauro, a strong advocate for indoor tanning regulation and on cancer issues, directly asked Dr. Hamburg the reason for the delay and the expected timeline for a reclassification determination, pointing out that the longer a final decision is delayed the more young women will become victims of skin cancer. Dr. Hamburg responded that the FDA would release a final determination by the end of this year. The AADA will continue to advocate for swift action, working with Rep. DeLauro to ensure the FDA carries out its commitment to issue a decision this year.

Federal agency focus

More RAC audits on the horizon: New pre-payment review demonstration project begins in June
At a recent briefing to the AMA and physician specialty societies, CMS officials stated that their 2012 goal for the Comprehensive Error Rate Testing (CERT) program is to have an adjusted improper payment rate of 5.4 percent. This rate is adjusted downward to capture appeal results and other factors approved by the Office of Inspector General (OIG). The 2011 improper payment rate was 8.6 percent, significantly higher than the goal for 2012. To help reach this aggressive goal, CMS will begin a new RAC initiative, the Recovery Audit Program Pre-payment Review Demonstration project, on or after June 1. This three-year demonstration project will be ongoing until May 2015. The focus will be on claims with high improper payment rates. While the RACs will begin reviewing claims for short inpatient hospital claims, it is expected that this will be expanded to other provider and claim types. This will be in addition to ongoing post-payment review audits. This demonstration will occur only in California, Florida, Illinois, Louisiana, Michigan, New York, Texas, Maryland, North Carolina, Ohio and Pennsylvania. Before June 1, the RACs will identify the issues for review on their websites. The Academy will be closely monitoring this demonstration project for additional information.

Dermatology urges Highmark Medicare Services to rescind restrictions on Mohs surgery
On March 8, the dermatology community collectively urged Highmark Medicare Services to rescind its draft local coverage determination (LCD) on Mohs surgery. The American Academy of Dermatology Association, the American College of Mohs Surgery (ACMS), the American Society for Dermatologic Surgery Association (ASDSA), and the American Society for Mohs Surgery (ASMS) submitted a joint comment letter to Highmark, arguing that the draft LCD would blanket deny coverage for any Mohs micrographic surgery performed on the trunk and extremities, even in cases where it would be clinically appropriate. Together, the AAD, ACMS, ASDSA and ASMS argued that there are clinical situations where Mohs surgery is both medically necessary and optimally cost effective for the treatment of trunk and extremities tumors. Highmark was urged to rescind the draft LCD based upon current Mohs treatment criteria data and pending the approval by the AAD, ACMS, ASDSA, and ASMS boards of directors and dissemination of the Mohs appropriate use criteria developed collaboratively by the stakeholder groups.

State policy roundup

Idaho House postpones vote on tanning ban
The Idaho House of Representatives postponed a floor vote planned for March 1 on legislation to ban tanning for minors, due to baseless accusations from the Idaho Freedom Foundation (IFF).  The group circulated an article from tanningtruth.com – an industry sponsored website – that inaccurately suggests dermatologists refer 900,000 patients a year to tanning salons for medical ultraviolet treatments.  The IFF urged policymakers in Idaho to reject HB 486 based on the IFF’s claim that the bill’s chief supporters, dermatologists, would financially prosper as a result of its passage.  On March 3, the AADA and the Idaho Dermatology Society responded to the IFF accusations in a strong statement to the press indicating that dermatologists would in no way financially benefit from the passage of HB 486, and in fact, the opposite is true if the bill’s passage will result in fewer future skin cancers.  The bill was returned to the House Health and Welfare Committee, where a hearing was held on March 6 and the bill was amended to prohibit use of tanning beds by minors under the age of 16 and require parental consent for minors 16 to 18.  Other amendments included specific statements to be made on the parental consent form and the posting of warning signs.  The bill will go back to the floor of the House of Representatives for a vote.

Kentucky, West Virginia legislatures play politics with tanning legislation
Legislation to regulate the indoor tanning industry has received unprecedented attention in state legislatures nationwide this year.  Unexpected actions have occurred on such bills in both Kentucky and West Virginia in the last few weeks.

In Kentucky, legislation that would ban tanning for minors under the age of 14 and require parental consent for teens 14 to 18 years old awaits a vote on the House floor. In the span of two weeks, amendments have been filed on the bill to prohibit tanning for all teens and young adults under 18; require only parental consent for all minors (removing the ban provision in the original version) and add a section to require an ultrasound prior to an abortion. The tactic of filing an abortion-related amendment onto legislation is used as a political maneuver to stop a bill from moving forward in the legislative process. Due to the tireless efforts of Academy members, Mark Zalla, MD, FAAD; Laura Klein, MD, FAAD; James Wharton, MD, FAAD; and others, the filed abortion amendment was withdrawn on March 2. The AADA and Kentucky Dermatology Society are urging withdrawal of the parental consent amendment and asking House leadership to bring HB 249 up for a vote. The Kentucky House of Representatives must pass the bill before March 23 in order for it to be eligible for consideration in the State Senate this session.

In West Virginia, as previously reported, SB 73 was amended and passed by the State Senate to prohibit youth under the age of 18 from using indoor tanning beds. In a hearing on Feb. 27, despite excellent testimony from Michelle Endicott, DO, the House Health and Human Resources Committee changed the bill to require only parental consent for minors under 18. The House Judiciary Committee failed to take action on March 7, rendering the bill dead for the remainder of the 2012 session. Advocates will regroup in the interim before next year’s session and develop a strategy to move this legislation forward in the future.

Utah legislature swiftly passes tanning and truth-in-advertising bills
Two bills of importance to the AADA and Utah Dermatology Society (UDS) await action by Gov. Gary Herbert. Legislation to require in-person parental consent and parental accompaniment for all visits to a tanning salon by minors under the age of 18 was passed by the State Senate on Feb. 22 and by the State House of Representatives on Feb. 29.

AADA and the UDS also worked closely with the American Society for Dermatologic Surgery Association, the American Society of Plastic Surgeons, the American Academy of Facial and Reconstructive Plastic Surgery, and the Utah Medical Association to support HB 126 to require disclosure of board certification and specialty in all advertisements for health care services in which a physician notes board certification. In addition, in order for physicians to advertise certification, their certifying board must meet specific requirements. This legislation passed the State House of Representatives on Feb. 13 and the State Senate on Feb. 23. Gov. Herbert must sign or veto the bills within 20 days of their passage or they will become law without his signature.

Dermatologists support tanning ban in Vermont
On Feb. 29, the AADA and the Vermont Dermatological Society collaborated to support a House bill that would prohibit the use of indoor tanning beds by minors in the state.  Academy members Kathryn Schwarzenberger, MD, FAAD; Landon Dennison, MD, FAAD; and dermatology resident Judy Wong, MD, testified in front of the House Committee on Health Care.  Other national and state organizations, including the National Council for Skin Cancer Prevention, the American Society for Dermatologic Surgery Association, the Prevent Cancer Foundation, the Vermont Chapter of the American Academy of Pediatrics, the Dermatology Nurses Association, the Society for Pediatric Dermatology, the Joanna M. Nicolay Melanoma Foundation, and the Melanoma International Foundation also registered their support for this legislation through written comments.

AADA, Mississippi Dermatological Society support transparency in provider credentials
On March 1, the AADA and Mississippi Dermatological Society (MDS) sent a letter of support to State Senate sponsors of a bill to require health care providers in the state to disclose their licensure and credentials in writing to all patients in advance of delivering health care services. The legislation also requires this disclosure in all medical advertisements. The bill is part of a national effort led by the American Medical Association and its Scope of Practice Partnership, on which the AADA serves as a steering committee member.

As activity on state legislation often happens quickly, Academy members can stay informed on all pending state legislation of importance to the specialty and view notes on AADA actions in real time on aad.org.

Resources to support state legislation on indoor tanning and truth in advertising can be found in the AADA’s online state advocacy toolkit.

Advisory Board policy resolutions sought
As the Annual Meeting approaches, the American Academy of Dermatology’s Advisory Board looks forward to hearing the voices of the Academy’s grassroots through the submission of proposed policy resolutions. The Advisory Board convenes every year to deliberate issues of importance to individual practitioners and bring proposed new policies to the Academy’s Board of Directors for consideration.

If there is an issue of interest and/or concern, now is your opportunity to submit a resolution from which an official Academy position might arise. In addition, the author or a designate must be present to introduce and discuss the resolution at the Reference Committee Hearing on Friday, March 16, 2012, in the Coronado Room of the San Diego Marriott at the Academy’s 70th Annual Meeting. The full Advisory Board will vote on resolutions at the General Business Meeting on Sunday, March 18, 2012. All resolutions and questions regarding the process should be directed to Barbara Greenan, staff liaison to the Advisory Board, at bgreenan@aad.org.

Political affairs – SkinPAC

Dr. Siegel is shaving his head if SkinPAC raises a million dollars
President-elect Dan Siegel, MD, is upping the ante in order to help make SkinPAC a $1 million per-election-cycle political action committee. He recently pledged to have his head and beard shaved in public if SkinPAC hits its fundraising goal. The first potential opportunity for this event will be the Plenary Session at the 2012 Annual Meeting in San Diego. If the goal is not met by March 16, 2012, SkinPAC will have additional opportunities to reach its $1 million goal by the 2012 Summer Academy Meeting and by Dec. 31, 2012.

SkinPAC, Dermatology Advocacy Network hosting reception at 2012 Annual Meeting
SkinPAC and the Dermatology Advocacy Network will host a joint after party on Reception Row at the 2012 Annual Meeting directly following the main Reception Row events for those who have a little more time to kill before their evening festivities begin. The doors will open at 6:30 p.m. on Friday, March 16, 2012 in San Diego Ballroom A of the San Diego Marriott and Marina.

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.

Contributions to SkinPAC are not deductible as charitable contributions for federal income tax purposes. SkinPAC cannot accept contributions from corporate accounts. All AADA members have the right to refuse to contribute without reprisal. Federal law prohibits us from accepting contributions from foreign nationals. Federal law requires us to use our best efforts to collect and report the name, physical address, occupation, and the name of the employer of individuals whose contributions exceed $200 in a calendar year.

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