House passes FY2013 budget resolution
The House-passed budget resolution follows the February release of the President’s FY2013 budget proposal and reflects significant spending and policy differences. Senate Democratic leadership has indicated that the Senate will not consider a budget proposal but will rather craft spending bills based on the spending levels previously agreed to in last year’s Budget Control Act. The AADA will continue to monitor these budget developments and their potential impact on the practice of dermatology.
AADA and AMA urge CMS to stop plans to back-date penalties
AADA and AMA object to the use of RAC contractors to conduct pre-payment review
The Recovery Audit Prepayment Review Demonstration will allow Medicare Recovery Auditors (RACs) to review claims before they are paid to ensure that the provider complied with all Medicare payment rules. The reviews will focus on seven states with high populations of fraud- and error-prone providers (Florida, California, Michigan Texas, New York, Louisiana, Illinois) and four states with high claims volumes of short inpatient hospital stays (Pennsylvania, Ohio, North Carolina, Missouri) for a total of 11 states.
The inadequacy of certain RACs in the administration of the recovery audit process, and the significant burden placed on physician practices to engage RACs and appeal inaccurate RAC determinations have been widely reported. The Academy, the AMA, and other specialty societies strongly object to the use of RAC contractors to conduct the pre-payment review process and have requested that CMS further apply all existing contractor regulations to RACs.
Aetna announces surgical pathology testing requirement
Aetna suggests that to avoid a “gap in payment,” CLIA and CAP accreditation should be submitted by May 1 for practices with both credentials, though Aetna has also extended the compliance deadline for practices interested in obtaining their CAP accreditation by or before Aug. 1.
The codes that are impacted are the surgical pathology codes 88300-88309, the special stains codes 88312 – 88314 (including histochemical staining with frozen sections(s)), and the pathology consultation codes 88342.
The Academy looks forward to collaborating with Aetna to ensure that its policies do not negatively impact the delivery of timely diagnostic services, which are integral to providing high-quality direct dermatologic care to patients in an office-based setting.
The American Academy of Dermatology is working to gather all the relevant information to inform an effective advocacy plan. As such, if you or your practice receives this policy change from Aetna, we ask that you share it along with your contact information to the Academy’s Government Affairs staff via email to email@example.com or via facsimile to (847)330-1120.
Anthem Blue Cross Blue Shield reverses modifier 25 reductions in Kentucky and Indiana
Beginning June 1, WellPoint will reimburse at 100 percent of the allowable amount for these E/M codes, rather than 50 percent of the allowable amount. However, WellPoint will maintain the 50 percent reduction for E/M codes billed with a modifier 25 with a preventive visit code. The AADA reminds members that claims for an E/M visit and a separate procedure on the same date require both services to be medically necessary and adequately documented, and that the modifier 25 should be added to the E/M code. The E/M service should reflect work above and beyond what is included in the procedure.
The AADA collaborated with dermatologists at the state level, as well as with the Indiana State Medical Association, the Indiana Academy of Dermatology, and the Kentucky Medical Society, to achieve this result.
Anti-indoor tanning advocates unite on Rhode Island bills
Tennessee dermatologists support regulation of the medical spa industry
California and New York pursue cosmetic medical procedure tax
On March 26, the New York State Department of Taxation and Finance issued an opinion on its policy regarding applicable sales tax on botulinum toxin and dermal filler cosmetic products. Medical drugs and devices are currently exempted from the state’s sales tax. As such, the sales tax exemption applies to dermal fillers when they are utilized to treat medical conditions such as facial lipoatrophy. The guidance document indicates that when used to treat medical conditions, illnesses, or diseases in patients, rather than for cosmetic purposes, it is the department’s policy that botulinum toxin compounds and dermal fillers will be treated as drugs or medicines. The AADA is working closely with the ASDSA, the New York State Society of Dermatology and Dermatologic Surgery, and the Medical Society of the State of New York to follow up with the department and other policymakers in the state on this issue.
SkinPAC surpasses $580K
Another way SkinPAC will be raising money this year will be to continue holding regional fundraisers. Clay J. Cockerell, MD, Seemal Desai, MD, and William Posten, MD, will host a fundraiser for SkinPAC on April 5 at 6:30 p.m. in Dallas at Cantina Larado. The goal of this particular event is to get residents and young dermatologists involved in SkinPAC by having a low-dollar function costing $60 to attend. It will feature AADA President Dan Siegel and U.S. Rep. Joe Barton (R-Texas).
Brent Moody, MD, and Pat Davey, MD, are taking the lead on hosting a SkinPAC fundraiser targeting Mohs surgeons on May 5, 2012. The event will be in Chicago to coincide with the American College of Mohs Surgery’s annual meeting. The location is still to be determined, but the reception will start at 7 p.m. Dr. Siegel also will play a key role to make this event a success.
To RSVP or find out more about SkinPAC and these events, please contact AADA’s manager of political affairs, at (202) 712-2609, or by email at firstname.lastname@example.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.
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.