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This week’s headlines:
Congressional action

AADA responds to Senate questions on Medicare payment reform
The American Academy of Dermatology Association (AADA) sent a letter in response to the Senate Finance Committee’s recent request to the physician and provider community for 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. Read the AADA’s letter.

Meanwhile, Republican members of the House Energy and Commerce Committee have released draft language for legislation that would repeal the SGR formula, and replace it with a reimbursement structure that calls for development of quality measures and promotes the development of new payment models. The AADA, along with other physician groups and stakeholder organizations participated in a briefing on May 28 at which Energy and Commerce Committee staff released the draft legislation. In addition, the Energy and Commerce Committee’s Health Subcommittee has announced plans to hold a hearing on June 5 to discuss and hear testimony regarding the legislative draft. The AADA will be providing feedback to the Committee in the coming weeks. More information regarding the draft is available at the Energy and Commerce Committee’s website.

Senate looks to grant FDA more authority over drug compounders
In response to last year’s nationwide meningitis outbreak linked to tainted steroids produced by a Massachusetts compounding company, the Senate Health, Education, Labor and Pensions (HELP) Committee has passed S 959, the Pharmaceutical Compounding Quality and Accountability Act, which would grant the U.S. Food and Drug Administration (FDA) more regulatory authority over prescription drug compounders and would clarify state and federal oversight of compounding facilities.

Specifically, the bill would grant the FDA authority over large compounders that produce sterile products without individual prescriptions, which are sold across state lines. State pharmacy boards would monitor compounders that make non-sterile products intended for individuals with a prescription, which are sold within state lines.

The American Academy of Dermatology Association has been working with other physician organizations and Senate HELP Committee staff to ensure that the bill does not threaten access to compounding drugs for patients with skin conditions and diseases. For more information, contact Christine O’Connor at coconnor@aad.org.

AADA calls on Congress to support exemption of pathology providers from EHR safe harbor rule
The American Academy of Dermatology Association (AADA) has recently signed on to a coalition letter urging key members of Congress to request that the Office of the Inspector General exempt pathology providers from the extension of the safe harbor rule for electronic health records (EHR). See related item below. The current safe harbor permits certain individuals and entities, including pathologists and clinical laboratories, to donate 85 percent of the cost of EHRs, as well as corresponding training programs, to a referring physician. In the letter, the groups expressed concern that the current safe harbor includes an incentive to tie specimen referrals to EHR donations, opening the door to coercive business practices that are not in the patient’s best interests and do not promote cost-efficient delivery of care. For more information on congressional advocacy activities, contact Whitney Tyler at wtyler@aad.org.

Federal agency focus

Calling all dermatologists: Take action to protect the public from the dangers of indoor tanning
The American Academy of Dermatology Association (AADA) is calling on its members to submit a comment letter to the FDA in support of the agency’s recent proposed order to strengthen regulations on indoor tanning devices.

On May 6, the FDA issued a proposed order that recommends against the use of tanning beds by minors under 18, calls for the reclassification of indoor tanning devices from a Class I to a Class II medical device, and would require labeling on indoor tanning devices that clearly communicates the risks of skin cancer to all users. Read more about the FDA proposed order.

This proposed order faces significant opposition from the indoor tanning industry, and the FDA needs to hear from the physicians who treat the victims of these dangerous devices. The AADA has developed a template letter for members to copy and submit to the FDA before the Aug. 7, 2013, deadline. Copy and paste the template letter, or contact Amanda Grimm at agrimm@aad.org for more information.

Federal agencies propose extension for safe harbor
The Department of Health and Human Services Office of Inspector General (OIG) and the Centers for Medicare and Medicaid Services (CMS) have both issued proposed rules that would extend the sunset date on the safe harbor provision to the federal anti-kickback statute. The agencies are also seeking comments on limiting who is classified as a “protected donor” under the exception within the physician self-referral Stark law regarding the donation of electronic health record (EHR) items and services to referring physicians. See related item above. Read CMS’s proposed rule and the OIG’s proposed rule.

The American Academy of Dermatology Association will provide comments to both the OIG and CMS before the June 10 deadline, opposing the extension of the sunset date for the safe harbor provision and an exception under the physician self-referral Stark law as it applies to laboratories that donate the cost of EHR to ordering physicians. For more information, contact Richard Martin at rmartin@aad.org.

Private payer activity

Laboratory Economics: Aetna will significantly reduce reimbursement for pathology services
The April 2013 issue of Laboratory Economics reported that effective July 1, Aetna will significantly reduce its reimbursement rates for anatomic pathology services. The article indicated that the reduction would result in reimbursement rates that are 50 percent of those paid under Medicare’s current Clinical Laboratory Fee Schedule.

The American Academy of Dermatology Association (AADA) is confirming the nature and scope of this change, and advises all members who are contracted with Aetna to:

  1. Double-check current provider service agreements to determine what impact Aetna’s potential new rate cuts would have on pathology services should this policy be implemented;
  2. Pay close attention to the contract’s notice provision, which explains the advance notice requirements — usually 60 to 90 days prior to any material changes to an agreement — a payer is obligated to provide;
  3. Check if you have received any official correspondence from Aetna notifying you of the proposed rate adjustment contractual change; and, if so, follow up with your assigned Aetna provider representative to confirm the details of the notification and what options are available within your contract.

In the meantime, the AADA is seeking further clarification from Aetna, and encourages members to be proactive in assessing their individual situations. As a best practice, the AADA advises dermatology practices to perform routine review of all managed care contracts to ensure that patients have access to quality dermatologic care. For more information, contact William Brady, AAD senior manager, Practice Management Resources, at (847) 240-1824 or wbrady@aad.org.

State policy roundup

Oregon governor signs under-18 indoor tanning ban legislation
Oregon Gov. John Kitzhaber has signed House Bill (HB) 2896 which will prohibit minors under the age of 18 from using indoor tanning devices unless a doctor’s prescription is provided. The new restrictions in HB 2896 take effect Jan. 1, 2014. Read more about the American Academy of Dermatology Association’s (AADA) advocacy efforts on HB 2896. For more information, contact Lisa Albany at lalbany@aad.org.

Clock ticking for indoor tanning bills in Connecticut, Illinois, and Nevada
Legislation prohibiting minors from indoor tanning has passed both chambers and will now be considered by the governors of Connecticut, Illinois, and Nevada to sign into law. In Connecticut, the House and Senate passed Senate Bill (SB) 872, 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. Connecticut Gov. Dannel Malloy will have five days to either sign or veto the bill before it automatically becomes law.

In Illinois, Gov. Patrick Quinn has less than 60 days to sign or veto House Bill 188 — which would ban minors under the age of 18 from using indoor tanning beds — before it becomes law. Chicago and Springfield have both recently passed city ordinances prohibiting minors under the age of 18 from using indoor tanning beds.

Similar legislation in Nevada, SB 267, prohibiting minors under the age of 18 from using indoor tanning beds, has passed the Assembly. Gov. Brian Sandoval will have five days to either sign or veto the legislation before it automatically becomes law. The American Academy of Dermatology Association (AADA) sent letters in support of all three bills. Read the AADA’s letters of support. For more information, contact Kersten Burns at kburns@aad.org.

Texas governor to consider legislation on indoor tanning, physician dispensing of hydroquinone
Texas Gov. Rick Perry must sign or veto Senate Bill (SB) 329 — legislation prohibiting the use of indoor tanning devices by persons under 18 — by midnight on June 16, or it becomes law without signature. 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.

Additionally, Gov. Perry will consider legislation recently passed by the House and Senate, SB 227, which would permit physicians to dispense aesthetic prescription drugs directly to the patient, including hydroquinone. For more information, contact Lisa Albany at lalbany@aad.org.

Maryland dermatologists urged to support revisions to indoor tanning parental consent form
The American Academy of Dermatology Association is calling on dermatologists in Maryland to submit comments to the Maryland Department of Health and Mental Hygiene (DHMH) supporting revisions that would strengthen the indoor tanning parental consent form.

The DHMH has proposed to simplify the language in the consent form and strengthen the language on the risks associated with indoor tanning and minors. The new form would also require that the consenting parent provide official government-issued identification as part of the verification process. Read more about the revisions to the consent form and submit a letter of support for the proposed revisions. For more information, contact Lisa Albany at lalbany@aad.org, or Blake McDonald at bmcdonald@aad.org.

New York looks to strengthen truth-in-advertising laws
Truth-in-advertising legislation recently introduced in New York would provide patients with necessary information about who is delivering their health care. Senate Bill (SB) 5493 would require that all advertisements for health care services identify the type of professional license and board certification, if applicable, held by health care professionals. In addition, SB 5493 would require all health care professionals to wear a name tag that clearly identifies the type of license held during all patient encounters. The American Academy of Dermatology Association sent a letter of support for SB 5493. For more information, contact Kersten Burns at kburns@aad.org. To learn more about truth-in-advertising visit the State Advocacy Toolkit.

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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