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This week’s headlines:
General advocacy news

AADA 2013 advocacy agenda approved by Board of Directors
The American Academy of Dermatology Association (AADA) Board of Directors has approved the AADA’s advocacy agenda for 2013, ensuring that dermatologists have an active role in shaping and implementing policies, legislation and regulations at the state and federal levels on the most pressing issues facing the specialty and its patients.

The AADA gathered feedback from key policy committees at the Academy’s 71st Annual Meeting in Miami Beach, Fla. in March to determine the most important advocacy priorities for dermatologists. Based on that feedback, the Council on Government Affairs, Health Policy and Practice reviewed, modified and approved the advocacy priorities for Board review. The issues that have been prioritized include physician payment and delivery system reform; preserving access to office-based services; protecting patient safety; protecting dermatologists’ scope of practice; promoting medical research; access to dermatologic care and treatments, and medical liability reform. Read the AADA’s 2013 Advocacy Agenda. Check your inbox for the June 7 edition of the Academy’s Member to Member e-newsletter for more detailed analysis on the 2013 AADA advocacy agenda. Contact the AADA Government Affairs Department with any questions or concerns at govtaffairs@aad.org.

Congressional action

Projected Medicare expenditures for 2015 will not trigger IPAB action
This week, the Centers for Medicare and Medicaid Services (CMS) confirmed that the projected spending levels for Medicare in 2015 will not exceed the levels that would trigger the need for the Independent Payment Advisory Board (IPAB) to make recommendations on reducing Medicare expenditures.

The IPAB, created under the 2010 health system reform law, is tasked with containing Medicare costs if Medicare costs exceed certain levels. The American Academy of Dermatology Association (AADA) has been steadfast in its opposition of the IPAB, arguing that it would set arbitrary limits on Medicare spending and place Medicare payment policy decisions in the hands of an unelected, unaccountable board within the executive branch. The AADA’s opposition to the IPAB has helped slow its implementation (see related item below). The IPAB has yet to be established as its members have not been nominated. Current projections point to IPAB not needing to make recommendations for several years, but the AADA and other physician and health care organizations remain concerned about IPAB’s future impact on patients’ access to care should it not be repealed.

Read the letter that Paul Spitalnic, acting chief actuary for CMS, sent CMS Acting Administrator Marilyn Tavenner about the projected 2015 Medicare expenditures. For more information, contact Whitney Tyler at wtyler@aad.org.

AADA joins more than 500 organizations opposing IPAB implementation
The American Academy of Dermatology Association (AADA) has signed on to a letter opposing the implementation of the Independent Payment Advisory Board (IPAB). The IPAB would be empowered to make recommendations to cut spending in Medicare if its spending growth reaches certain arbitrary levels. The coalition of more than 500 groups argued that implementation of the IPAB would not only negatively impact Medicare beneficiaries’ access to care, but also increase health care costs.

Additionally, the coalition stressed the concern that implementation of the IPAB would set a dangerous precedent for overriding the standard legislative process – arguing that an unelected and unaccountable board would remove elected officials from the decision-making process and endanger the important dialogue that takes place between elected officials and their constituents. Read more from the coalition letter.

In January, the AADA supported the Protecting Seniors’ Access to Medicare Act which would repeal the Independent Payment Advisory Board (IPAB). Read the letter that the AADA sent to lead sponsor and author of the bill, Rep. Phil Roe. Read the letter that the AADA sent to co-sponsor Rep. Allyson Schwartz. For more information, contact Whitney Tyler at wtyler@aad.org.

AADA sponsors Capitol Hill briefing and free public skin cancer screening event
In an effort to increase skin cancer awareness and commemorate Melanoma/Skin Cancer Detection and Prevention Month®, the American Academy of Dermatology Association (AADA) will hold a skin cancer screening for legislators, their staff and the general public in the Cannon Caucus Room on Capitol Hill on May 7, 2013.

The AADA will also hold a congressional briefing on skin cancer awareness and the dangers of indoor tanning in cooperation with Rep. Charlie Dent (R-Penn) and Rep. Carolyn Maloney (D-N.Y.), the American Cancer Society Cancer Action Network, the American College of Mohs Surgery, the American Society for the Dermatologic Surgery Association, the American Society for Mohs Surgery, the Melanoma Research Foundation, National Council on Skin Cancer Prevention, and The Skin Cancer Foundation.

Featured speakers will include Brett Coldiron, MD, president-elect of the AADA; Rep. Maloney; Rep. Dent; Sen. Jack Reed (D-R.I.); Sen. Johnny Isakson (R-Ga.); RADM Boris D. Lushniak, MD, MPH, deputy surgeon general and a dermatologist; Alyson Fuller, Ph.D., a former indoor tanner and melanoma skin cancer survivor, and Johnny Bench, Baseball Hall of Famer and skin cancer survivor. Read more about the Capitol Hill skin cancer briefing and screening.

The AADA has been working closely with regulatory agencies, and both state and federal legislatures to protect minors from the dangers of indoor tanning. Learn more about the AADA’s congressional indoor tanning activities. For more information, contact Christine O’Connor at coconnor@aad.org.

Federal agency focus

AADA recommends policy changes to CMS, ONC to improve use of electronic health records
Citing technical barriers, privacy concerns and onerous costs as obstacles for physicians to share clinical data electronically, the American Academy of Dermatology Association (AADA) recently sent a letter suggesting several policy changes that would advance electronic health record (EHR) interoperability and health information exchange to the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC).

The AADA urged CMS and the ONC to encourage open-source software development — software that is often developed in a public, collaborative manner — which would spur innovation and interoperability of systems from software vendors. The AADA also reiterated its concerns about the ability for small practices to afford EHR systems. Additionally, the AADA called on CMS and the ONC to create a hardship exemption from meaningful use requirements for physicians in and near retirement to avoid intensifying workforce shortages. Read the AADA’s letter to CMS and the ONC. For more information, contact Richard Martin at rmartin@aad.org.

FDA issues safety alert on counterfeit onabotulinumtoxinA
The U.S. Food and Drug Administration (FDA) has issued a safety alert that a company that goes by the names Online Botox Pharmacy, Onlinebotox.com, and Onlinebotox has been selling counterfeit Botox to physicians in the United States. The product’s packaging is counterfeit, while the vial inside is labeled as a foreign version of Botox, which is not FDA-approved for sale in the United States. The FDA warns that these medications are unsafe, and therefore advises that physicians stop administering these unapproved versions of Botox.

FDA-approved Botox, manufactured by Allergan, displays the active ingredient as “OnabotulinumtoxinA” on the outer carton and vial. Counterfeit Botox will show that the active ingredient is “Botulinum Toxin Type A” on the outer carton. Also, the lot numbers and expiration dates on the outer carton and the product vial will not match. Read more FDA advice for health care providers on this issue. The American Academy of Dermatology Association will provide updates as they are made available. For more information, contact Amanda Grimm at agrimm@aad.org.

State policy roundup

Indoor tanning legislation introduced in Nevada, Ohio; moves forward in Missouri, Illinois, West Virginia
Nevada and Ohio are the two latest states to introduce legislation banning the use of indoor tanning devices for minors under the age of 18. In Ohio, House Bill (HB) 131 was referred to the House Health Committee and Senate Bill (SB) 113 was referred to the Senate Commerce and Labor Committee. In Nevada, the Senate introduced SB 267 which would have required parental consent for minors but was amended to ban minors under the age of 18 from indoor tanning. The Senate passed this bill and it will be heard in the Assembly Commerce and Labor committee on May 10.

Similarly, Missouri HB 47 has passed the state House and will go to the Senate. HB 47 would require any minor less than 17 years of age to obtain in-person parental consent annually to use an indoor tanning device. The American Academy of Dermatology Association (AADA) recently sent a letter of support for HB 47 to state Sen. Brian Nieves, the chair of the Senate General Laws Committee.

Illinois took one step closer to joining California and Vermont in instituting a state-wide ban on minors under the age of 18 using indoor tanning devices. Both chambers have passed legislation that would ban minors under the age of 18 from using indoor tanning beds. However, HB 188 — which would ban minors under the age of 18 from using indoor tanning beds—passed in the Senate Executive Committee and is awaiting a vote by the full Senate before it can be sent to the governor for signature. Chicago and Springfield have both recently passed city ordinances prohibiting minors under the age of 18 from using indoor tanning beds.

In West Virginia, Gov. Earl Ray Tomblin signed SB 464 on May 1. The bill prohibits the use of indoor tanning devices by persons under the age of 14. Minors ages 14 to 17 must have written, in-person parental consent to use indoor tanning devices. SB 464 was introduced as an under-18 ban, but was amended in the House. It will go into effect on July 12.

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.

Oregon House and Senate divided on indoor tanning age restrictions
The Oregon state House and Senate have disagreed on the specific age restrictions for indoor tanning. In Oregon, House Bill (HB) 2896 would prohibit minors under the age of 18 from using an indoor tanning device without a doctor’s note. The Senate recently passed the bill, however, amending the age restriction to minors under the age of 17. The House rejected the change and a conference committee was appointed to prepare a version of the bill that both chambers will approve. Read the American Academy of Dermatology Association’s letter of support for HB 2896. For more information, contact Kersten Burns at kburns@aad.org.

Florida biosimilar legislation would remove provider-notification requirement
The American Academy of Dermatology Association (AADA) and the Florida Society of Dermatology and Dermatologic Surgery (FSDDS) have sent a joint letter of opposition to the Florida Senate regarding biosimilar legislation that would remove the requirement that pharmacists inform the health care provider of a biosimilar substitution. Engrossed House Bill 365 removed the notification requirement arguing that it would impede access or cause significant burden on the pharmacy.

In its letter, the AADA and FSDDS argue that by omitting physician notification, patient safety could be jeopardized. Requiring a notification period 24-hours prior to the substitution could prevent adverse outcomes and ensure that the physician is aware a change in therapy occurred, if the patient experiences an adverse effect. Read the AADA's comment letters on Engrossed House Bill 365. 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 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 that are interested in pursuing a mayoral or gubernatorial proclamation can contact Victoria Houghton for assistance.

Upcoming events

Register for the 2013 AADA Legislative Conference
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. Registration is now open for this conference, which 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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