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This week’s headlines:
Congressional action

Preserve your voice in the house of medicine — join the AMA, designate AAD as your primary organization
This is the year that the American Medical Association (AMA) is reviewing how many members of the American Academy of Dermatology (AAD) are also AMA members. The AMA conducts a five-year review of a subset of organizations each year to determine the number of voting representatives that each specialty will receive in the AMA House of Delegates (HOD) for the next five years. By joining or renewing your AMA membership and designating the AAD as your specialty organization, you ensure the specialty’s presence and voice in affecting the house of medicine’s priorities. If dermatologists don’t maintain a strong presence in the AMA, the specialty will lose its voice in an important venue. Renew your membership or join the AMA before April 15 and indicate the AAD as your primary organization of membership to ensure that dermatology has a voice in the house of medicine.

House Committees refine proposal on Medicare physician payment reform
In response to the feedback received from the American Academy of Dermatology Association (AADA) and other members of the physician community, the House Ways and Means Committee and the Energy and Commerce Committee have released an updated version of their recent proposal that would repeal the sustainable growth rate (SGR) formula and eliminate the estimated 24.4 percent across-the-board Medicare rate cut scheduled to go into effect on Jan. 1, 2014.

In a letter sent last month, the AADA agreed with several aspects of the original proposal. However, the AADA did express concern regarding the use of the term “efficiency” without clearly defining the term, and urged the committees to allow physicians and their respective specialty societies to define quality measures. In addition, the AADA stressed the need to maintain Fee-For-Service (FFS) as an option for physician practices and specialties that do not necessarily fit into various alternative payment models. Read the AADA’s letter on SGR reform. The latest proposal provides clarity on how the Committees' payment reform proposal would reward providers, through both alternative payment models and FFS, for high-quality and efficient care, and how it would go about determining evidence-based and specialty-specific quality and efficiency measures. Read the Committees’ letter and detailed proposal.

The AADA will submit comments to the Committees on this latest proposal before the April 15 deadline. For more information or to provide feedback on the Committees’ proposal, contact the AADA at govtaffairs@aad.org.

Sequestration cuts to Medicare physician payment in effect; AADA resources available
Across-the-board sequestration cuts to most federal programs went into effect on April 1. As a result, Medicare fee-for-service claims with dates of service, or dates of discharge, on or after April 1, 2013, will incur a 2 percent reduction. The American Academy of Dermatology Association (AADA) has developed a list of frequently asked questions about the sequestration cuts and how they will affect physician practices and patients. Read the AADA Sequestration FAQs. The AADA will continue to advocate on behalf of the specialty and its patients, and will monitor this issue and provide updates as more information becomes available. For more information, contact the AADA Government Affairs Department at govtaffairs@aad.org.

AADA supports legislation that addresses physician shortages
The American Academy of Dermatology Association (AADA) has sent a letter to Rep. Aaron Schock (R-Ill.) and Rep. Allyson Schwartz (D-Pa.) commending them for introducing legislation that would increase graduate medical education (GME) slots. The Training Tomorrow’s Doctors Today Act addresses the growing physician shortage crisis by increasing GME slots by 15,000 over the next five years, while adding accountability measures. In its letter, the AADA cited recent research that projects non-primary care subspecialties like dermatology will endure a shortage of 64,000 medical and surgical specialists by 2020. Read the AADA’s letter of support. For more information, contact Shawn Friesen at sfriesen@aad.org.

House subcommittee reviews health information technology efficacy, regulations
The House Energy and Commerce Subcommittee on Health recently held hearings to discuss the role that emerging trends in health information technologies (HIT) – such as smartphones and medical applications – play in advancing patient care. Comments were made about the efficacy and safety of some technologies and medical applications that are sometimes used in dermatology and telemedicine to detect melanomas.

The subcommittee also discussed potential regulations and taxes that could entail the implementation of such technologies for medical purposes. Following the hearing, the Food and Drug Administration announced that it would not consider medical applications and smartphones as medical devices, therefore exempting them from the medical device tax.

The American Academy of Dermatology Association will continue to work with House Energy and Commerce Subcommittee staff on advancements in HIT as they relate to the practice of dermatology. For more information, contact Whitney Tyler at wtyler@aad.org.

Private payer activity

BCBS Minnesota delays coding change denying E/M services with a procedure
Blue Cross and Blue Shield (BCBS) of Minnesota has temporarily delayed the implementation of a coding edit that would deny evaluation and management (E/M) services 99214 and 99215 when submitted on the same day as a procedure. This change was inadvertently activated on Oct. 12, 2012. Although BCBS of Minnesota still plans to implement this change, it has indicated that the activation date did not provide ample time for physicians to prepare for the change. BCBS of Minnesota will review claims processed from Oct. 1, 2012, through Jan. 20, 2013. The American Academy of Dermatology Association will continue to monitor the impact of this change and will provide updates as more information becomes available. For questions or for more information, contact Jacqueline Buschmann at jbuschmann@aad.org.

State policy roundup

New Jersey prohibits indoor tanning for minors under 17
New Jersey has passed a law that bans minors under the age of 17 years old from using indoor tanning devices. Legislation prohibiting the use of indoor tanning beds by minors under 17 passed both the New Jersey General Assembly and Senate in February. Gov. Christopher Christie signed the bill into law on April 1, 2013. The law will go into effect on Oct. 1, 2013.

A-2142/S-1172 was sponsored by Assembly Members Ralph Caputo, Gordon Johnson, Louis Greenwald, Herbert Conaway, and Pamela Lampitt, and Senators Loretta Weinberg and Robert Singer. Support for the ban was provided by the American Academy of Dermatology Association (AADA), the Dermatological Society of New Jersey, and the American Society for Dermatologic Surgery Association. Read a press release issued by the AADA. New Jersey is the latest state to pass legislation that limits the use of indoor tanning by young people. California, New York, Vermont, and Springfield and Chicago, Ill. have passed laws prohibiting the use of indoor tanning devices by minors. For more information, contact Lisa Albany at lalbany@aad.org.

FTC responds to Connecticut legislation that would increase scope of advanced practice nurses
In response to a request for information from Connecticut State Rep. Theresa W. Conroy, the Federal Trade Commission (FTC) has advised that the state look into allowing advanced practice registered nurses (APRNs) to diagnose, treat, and prescribe medications for their patients in accordance with their licensed scope of practice, without a collaboration arrangement or agreement with a physician. Read the FTC’s comments. In recent years, the FTC has been commenting on state scope of practice legislation and proposed regulation. In 2012, the FTC submitted comments concerning scope of practice in West Virginia, Kentucky, Colorado, Louisiana, and Missouri.

Current Connecticut law requires that an APRN obtain a collaborative practice arrangement with a physician before the APRN may offer health care services within his or her established scope of practice. However, Connecticut House Bill (HB) 6391 would change that. The FTC indicated that removing this requirement could expand choices for patients, contain costs, and improve access to care. However, the FTC strongly encourages the state to carefully review patient safety considerations prior to passing HB 6391.

The AADA and the Connecticut Dermatology and Dermatologic Surgery Society (CDDSS) have sent a letter of opposition reiterating its position that coordinated-care teams, including APRNs but led by a physician, are a critical component to the health care delivery system. The AADA and CDDSS expressed their concerns that an APRN’s education and training is not sufficient for independent practice, and could therefore jeopardize patient safety. Read the AADA and CDDSS’s letter of opposition to HB 6391. For more information, contact Lisa Albany at lalbany@aad.org.

Indoor tanning legislation in Connecticut moves forward
Legislation that would protect minors from the dangers of indoor tanning in Connecticut has passed out of committee and will proceed to the Senate for debate. Connecticut Senate Bill (SB) 872 would prohibit the use of indoor tanning devices by minors under the age of 18. Read the American Academy of Dermatology Association’s (AADA) letter of support.

Maine governor vetoes indoor tanning ban
Gov. Paul LePage has vetoed legislation in Maine that would ban minors under the age of 18 from using indoor tanning devices. The Maine House gave the bill, LD 272, preliminary approval last week and the Senate passed the bill on Wednesday. However, Gov. LePage vetoed the bill shortly thereafter citing that current law – which requires parents to provide consent in order for minors to use tanning devices – is sufficient and that the decision should be made by parents and not the government. Read the AADA and Maine Dermatological Society’s letter of support. For more information, contact Kersten Burns at kburns@aad.org.

AADA supports West Virginia under-18 indoor tanning ban
The American Academy of Dermatology Association (AADA), the West Virginia Dermatologic Society (WVDS), and the American Society for Dermatologic Surgery Association (ASDSA), have submitted a letter of support for Senate Bill 464, which would prohibit minors under the age of 18 from using indoor tanning devices.

The AADA has been providing assistance to state societies that are 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.

AADA supports name-badge requirements in West Virginia
The American Academy of Dermatology Association (AADA) has sent a letter supporting West Virginia Senate Bill (SB) 21, which would require health care professionals to wear identification badges. The purpose of the badges would be to better inform patients of the health care professional’s name and title when providing direct patient care.

In its letter, the AADA reiterated its support for team-based models of health care delivery, led by the physician, and recognized the vital role all providers play in the health care delivery system. However, the AADA added that ambiguous provider nomenclature, related advertisements and marketing, and the myriad of individuals that patients encounter in each point of service can exacerbate patient confusion about who is providing their health care. Further, patient autonomy and decision-making are jeopardized by uncertainty and misunderstanding in the patient-provider relationship. Read the AADA’s letter of support. For more information, contact Lisa Albany at lalbany@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

Register for the 2013 AADA Legislative Conference
Registration for the 2013 AADA Legislative Conference is now open. The American Academy of Dermatology Association (AADA) is pleased to invite the entire Academy membership to attend the 2013 AADA Legislative Conference on Sept. 8-10, in the heart of Washington, D.C. This conference offers the unique opportunity to hear from health policy experts, discuss dermatology issues with colleagues, attend advocacy training taught by D.C. insiders, and become the trusted and influential voice your members of Congress can rely on. Conference attendees learn about critical health policy issues from national health policy experts, political insiders, and AADA advocacy leaders. Visit the conference Web page to learn more and register for this premier event. For more information, contact Blake McDonald at bmcdonald@aad.org.


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