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This week’s headlines:
Congressional action

AADA hosts congressional briefing and free public skin cancer screenings on Capitol Hill
The American Academy of Dermatology Association (AADA), in cooperation with Rep. Charlie Dent (R-Penn.) and Rep. Carolyn Maloney (D-N.Y.), celebrated Melanoma and Skin Cancer Prevention and Detection Month® on Tuesday, May 7, by hosting a congressional briefing and skin cancer screening on Capitol Hill in Washington, D.C. This event was intended to raise awareness about melanoma, encourage early detection of skin cancer, and to educate the public about sun safety strategies, such as discouraging tanning bed use, to prevent future skin cancer incidences.

The briefing featured Brett Coldiron, MD, FAAD, president-elect, AADA; Rep. Dent; Sen. Jack Reed (D-R.I.), skin cancer prevention advocate; Sen. Johnny Isakson (R-Ga.), skin cancer survivor; RADM Boris D. Lushniak, MD, MPH, Deputy Surgeon General and a dermatologist; Alyson Fuller, Ph.D., former indoor tanner and melanoma skin cancer survivor; and Johnny Bench, Baseball Hall of Famer and skin cancer survivor. Other representatives attending the event included Rep. Brett Guthrie (R-Ky.), Rep. Brad Wenstrup (R-Ohio), and Trey Radel (R-Fla.).

A contingent of national organizations joined the AADA to highlight the dangers of indoor tanning including the American Cancer Society Cancer Action Network, the American College of Mohs Surgery, the American Society for Dermatologic Surgery Association, the American Society for Mohs Surgery, the Melanoma Research Foundation, the National Council on Skin Cancer Prevention, and The Skin Cancer Foundation. Following the briefing, seven AAD member dermatologists conducted 69 free skin cancer screenings for Capitol Hill staff and the general public.

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.

AADA to weigh in on Senate Medicare reform proposals
Last week, the Senate Finance Committee sent an open letter to the physician and provider community requesting input on how to reform the flawed Medicare physician payment system. Without congressional action, the sustainable growth rate (SGR) formula — which is used to calculate Medicare physician payments — would require an estimated 24.4 percent on Jan. 1, 2014.

In the letter, Senate Finance Committee Chairman Max Baucus (D-Mont.) and Ranking Member Orrin Hatch (R-Utah) called on providers to suggest reforms that would ensure that physician services are valued appropriately, policies that could work with the current fee-for-service (FFS) system, and incentives that could encourage physician participation in alternative payment models. Read the Senate Finance Committee letter.

The Senate Finance Committee also held a hearing on May 14 to discuss the need to replace the SGR formula. Sens. Baucus and Hatch called on the committee to replace the SGR this year, reiterating a key advantage in the Congressional Budget Office’s (CBO) reduction of the estimated cost for repealing the SGR — from an estimated $243.7 billion to just under $140 billion over the next 10 years. On Tuesday, CBO released updated numbers, which estimates the cost of SGR repeal at $139.1 billion over the next decade.

In April, the AADA sent recommendations to the House Ways and Means Committee and the Energy and Commerce Committee regarding their recent proposal on Medicare payment reform. Read more about the AADA’s recommendations on SGR reform. The AADA will submit comments to the Senate Finance Committee prior to the May 31 deadline. For more information, contact the AADA at govtaffairs@aad.org.

Senate confirms Tavenner as CMS administrator
Marilyn Tavenner has been confirmed, by a 91-7 vote, as the new permanent administrator for the Centers for Medicare and Medicaid Services (CMS). Tavenner has served as acting administrator for the CMS since 2011. In April, the American Academy of Dermatology Association (AADA) sent a letter of support to Sens. Max Baucus (D-Mont.) and Orrin Hatch (R-Utah) — the respective Chair and Ranking Member of the Senate Finance Committee — regarding Tavenner’s nomination, citing her unique ability to draw bipartisan support from congressional leaders and the health care community. In its letter of support, the AADA reiterated that Tavenner is well-positioned to lead CMS as it faces the challenges of implementing key provisions of the Affordable Care Act. Read the AADA’s letter of support.

AADA recommends policy changes to improve use of electronic health records
The American Academy of Dermatology Association (AADA) sent a letter to several members of the U.S. Senate suggesting policy changes that would advance electronic health record (EHR) interoperability and health information exchange.

The AADA’s response stemmed from a recently issued white paper titled “REBOOT: Re-Examining the Strategies Needed to Successfully Adopt Health IT,” which was authored by Sen. John Thune (R-S.D.), Sen. Lamar Alexander (R-Tenn.), Sen. Pat Roberts (R-Kan.), Sen. Tom Coburn, MD (R-Okla.), Sen. Richard Burr (R-N.C.), and Sen. Mike Enzi (R-Wyo.). The white paper summarized the key implementation deficiencies for adopting health information technology (HIT) as increased costs, lack of oversight, patient privacy risks, program sustainability, and the lack of a clear path for interoperability.

The AADA recommended instituting vendor-driven solutions to improve interoperability, and reiterated its concerns about the ability for small practices to afford EHR systems. Additionally, the AADA called for the creation of a hardship exemption from meaningful use requirements for physicians in and near retirement to avoid intensifying workforce shortages.

The AADA also addressed several of the authors’ concerns about alleged fraud and abuse with meaningful use payments, and potential “upcoding.” The AADA addressed these allegations and noted that many of the entities accepting payments have invested considerably more than the incentive payments they received in their electronic health record infrastructure, with little assurance that they would reap the full benefit of their investment. Citing a lack of hard evidence that physicians are upcoding, the AADA also noted that the issues may not be a physician problem, but may be linked to software programming issues. Read the AADA’s response letter. For more information, contact Shawn Friesen at sfriesen@aad.org, or Richard Martin at rmartin@aad.org.

Federal agency focus

FDA proposes stricter regulations on indoor tanning devices
The U.S. Food and Drug Administration (FDA) has proposed changes to its regulation of tanning devices, including a strong recommendation against the use of tanning beds by minors under the age of 18. The American Academy of Dermatology Association (AADA) has been working closely with the FDA in support of greater restrictions on tanning devices, and supports the proposed reclassification as well as additional restrictions on indoor tanning. Read a statement issued by the AADA shortly after the announcement.

The FDA announced that it is proposing to raise the classification for sunlamps and tanning beds to a Class II level which institutes stricter regulations to protect the public health. Currently, indoor tanning devices are Class I, the category for items that have minimal potential to cause harm to individuals, such as adhesive bandages and tongue depressors. Read more about the FDA’s proposed order on tanning devices.

The AADA recognizes that there is still more work to be done to protect the public from these dangerous devices, and will continue to work closely with the FDA and state legislative and regulatory bodies to prohibit the use and sale of indoor tanning devices for minors under the age of 18. Read the AADA’s position statement on indoor tanning. The AADA will provide comments in support of these regulations prior to the 90-day deadline, and will continue to communicate to the FDA the need for stricter regulations on the use and sale of indoor tanning devices. Contact Amanda Grimm, senior specialist, AADA regulatory policy at agrimm@aad.org for more information.

State policy roundup

Under-18 indoor tanning ban bills sent to governors in Texas, Oregon; die in Alabama, Florida
Texas and Oregon could be the next states to pass legislation that would protect minors from the dangers of indoor tanning. Texas Senate Bill (SB) 329, legislation prohibiting the use of indoor tanning devices by persons under 18, has passed both the Texas House and Senate and has been sent to Gov. Rick Perry’s desk to sign into law or veto.

Gov. Perry must sign or veto the bill within 10 days, or it becomes law without signature. If Gov. Perry vetoes the legislation, a two-thirds vote in each house will be required to override his veto. Read the letter of support from the American Academy of Dermatology Association (AADA) on Senate Bill 329. For Texas-based dermatologists looking to share their support for SB 329 with Gov. Perry, contact his office by calling (512) 463-2000, or send a message via Gov. Perry’s website.

In Oregon, House Bill (HB) 2896 has passed the House and Senate and has been sent to Gov. John Kitzhaber, MD. The Governor has indicated that he will sign the bill into law. HB 2896 prohibits minors under the age of 18 from using indoor tanning devices. The Oregon Dermatology Society, the Oregon Health & Science University Department of Dermatology (OHSU Dermatology), and the AADA, sent a letter of support for this bill to the Oregon Senate Committee on Health Care and Human Services in March.

Legislation banning minors from indoor tanning in Alabama and Florida died in committee last week. As introduced, Alabama HB 179 and Florida SB 1674 would have prohibited minors under the age of 18 from using indoor tanning devices. For more information, contact Kersten Burns at kburns@aad.org.

AADA, New Jersey dermatologists testify against bill that would prohibit in-office procedures
Representatives of the American Academy of Dermatology Association (AADA) and the Dermatological Society of New Jersey (DSNJ) testified before the New Jersey Senate Health, Human Services and Senior Citizens Committee against S-2079 — legislation that would restrict where certain office-based procedures may be performed. Similar legislation, Assembly Bill 1824, is pending in the New Jersey Assembly.

S-2079 would require that operations — such as liposuction procedures that involve more than 750 cubic centimeters of aspirate, procedures that utilize a breast implant, and aesthetic truncal contouring procedures involving the excision of skin — take place in accredited ambulatory surgery centers and hospitals.

The AADA and DSNJ argued that this legislation could in fact hinder patient safety, access to dermatological procedures, and lead to even higher health care costs in New Jersey. Additionally, the groups argued that the passage of this bill could set a precedent for legislation that would not ensure patient safety, but rather negatively affects patient access to minor surgeries, which are safely performed in physician offices. Read the AADA’s letter of opposition. For more information, contact Lisa Albany at lalbany@aad.org.

Indoor tanning legislation moves forward in Nevada, Ohio, Pennsylvania and Connecticut
Several states are moving closer to instituting indoor tanning bans on minors. In Nevada, Senate Bill (SB) 267, which would prohibit minors under 18 from using indoor tanning beds, was heard last week by the Assembly Committee on Commerce and Labor, and is currently awaiting a vote. Read the AADA’s letter of support on SB 267.

Ohio’s House Bill (HB) 131, which would also prohibit minors under 18 from using indoor tanning devices, was heard in the House Health and Aging Committee on Wednesday and is awaiting a vote. Similar legislation, SB 113, was introduced in the Ohio Senate and is awaiting a Senate hearing. Read the AADA’s letter of support for HB 131.

In Pennsylvania, HB 1259 which would prohibit minors under 17 from using indoor tanning devices was heard by the House Health Committee this week and passed unanimously. The bill now awaits a vote by the full House. The Philadelphia City Council is considering an ordinance, Bill Number 130057, that would prohibit any minor under 14 years from using an indoor tanning device without a prescription. Bruce Brod, MD, FAAD, testified on behalf of the proposed ordinance this week. The ordinance passed unanimously out of committee and will go to the full council for consideration. Read the AADA and Pennsylvania Academy of Dermatology and Dermatologic Surgery’s letters of support for HB 1259 and Philadelphia Bill Number 130057.

In Connecticut, the Senate passed indoor tanning bill SB 872 unanimously, which would ban indoor tanning for minors under the age of 17. The bill was amended prior to passing, lowering the age restriction from under 18. The bill will now go to the House.

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.

Biosimilar legislation reaches Florida governor; dies in Colorado
Legislation regulating the dispensing of interchangeable biosimilars, House Bill (HB) 365, passed the Florida legislature and is on its way to Gov. Rick Scott for signature. The bill would 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 American Academy of Dermatology Association (AADA) and the Florida Society of Dermatology and Dermatologic Surgery initially supported HB 365. However, the groups sent a joint letter of opposition to the Florida Senate when the bill was altered and, as a result, the requirement that pharmacists inform the health care provider of a biosimilar substitution was removed. The notification requirement was removed because legislators argued that it would impede access or cause significant burden on the pharmacy. Read the AADA's comment letters on Engrossed House Bill 365.

Similar legislation has died in Colorado. The AADA worked with the Colorado Dermatologic Society to send a letter of support for Colorado HB 1121, which was similar to the original version of Florida HB 365.

To learn more about biosimilars and dermatology, review the AADA’s position statement on generic therapeutic and biosimilar substitution and look for a feature article in the June 2013 issue of Dermatology World. For more information, contact Lisa Albany at lalbany@aad.org.

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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