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This week’s headlines:
Congressional action

AADA to Capitol Hill: Replace the Medicare payment formula; promote quality of care
The American Academy of Dermatology Association (AADA) is calling on Congress again to repeal the flawed Medicare physician payment system and replace it with a new reimbursement system that recognizes the rising costs of medical practice and promotes efforts to improve quality of care. The AADA sent recommendations to the House Energy & Commerce Committee after the Committee requested input from the physician and provider community on how to reform the sustainable growth rate (SGR) formula.

The AADA has responded to questions and proposals from Capitol Hill on four separate occasions this year in an effort to repeal and replace the formula before Jan. 1, 2014, when Medicare payments are expected to face an estimated 24 percent cut. More information regarding the draft is available at the Energy and Commerce Committee’s website. Read the AADA’s letter and response to the Committee’s questions. For more information, contact Whitney Tyler at wtyler@aad.org.

AMA House of Delegates takes on Medicare payment, health reform at annual meeting
At its annual House of Delegates (HOD) meeting June 15-19, the American Medical Association (AMA) approved a resolution to work with the Centers for Medicare and Medicaid Services and private payers to ensure that quality measures used to determine physician payment will be limited to those under direct physician control and will only include subjective criteria, such as patient satisfaction surveys, as adjunctive rather than determinative. Other adopted resolutions included one that supports the right of physicians to determine their practice and payment models. Also, the AMA approved a resolution to refine its position on the Affordable Care Act, noting its support for private contracting and the repeal and replacement of the sustainable growth rate (SGR) formula, as well as its opposition to the Independent Payment Advisory Board (IPAB). More information about the AMA HOD annual meeting will be reported in the July 19 issue of Member to Member and the August 2013 issue of Dermatology World. Questions about the AMA dermatology delegation can be directed to Abigail Osborne at aosborne@aad.org.

Medicare audits scrutinized at Senate Finance Committee hearing
At a hearing this week, Senate Finance Committee Chairman Max Baucus (D-Mont.) and Ranking Member Orrin Hatch (R-Utah) called for the streamlining of the Medicare Recovery Audit Contractor (RAC) program to alleviate unreasonable administrative burdens on hospitals and providers. At Tuesday’s hearing, the Senators agreed that reducing the amount of improper payments is necessary to ensure the financial longevity of the Medicare program; however, they suggested improving the efficiency of the appeals process, providing more clear regulations for providers, and focusing the audits on the services and providers that are more at risk for fraud. While the American Academy of Dermatology Association (AADA) will continue to monitor these latest developments, the AADA has developed a RAC Audit Survival Toolkit for physicians who may be subject to audits. To either watch or read more about the hearing, visit the Senate Finance Committee’s website: Program Integrity: Oversight of Recovery Audit Contractors. For more information, contact Shawn Friesen at sfriesen@aad.org.

AADA applauds legislation that would improve patient access to specialty drugs
The American Academy of Dermatology Association (AADA) sent a letter to Reps. David B. McKinley (R-W.Va) and Lois Capps (D-Calif.) commending them for introducing the Patients’ Access to Treatments Act, H.R. 460, which would require insurers to charge no more for specialty drugs than they currently charge for non-specialty drugs. The AADA expressed its support for the legislation and reiterated that dermatologists often treat patients with chronic inflammatory, multi-system, disabling, and life-threatening conditions. Therefore, this legislation would help provide greater treatment access for those patients where no generic or inexpensive equivalent exists. Read the AADA’s letter of support. For more information, contact Christine O’Connor at coconnor@aad.org.

Federal agency focus

Dermatologists flood FDA with letters supporting tanning bed reclassification
More than 200 dermatologists have submitted comment letters to the Food and Drug Administration (FDA) in support of the agency’s recent proposal to strengthen regulations of tanning beds. 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.

The American Academy of Dermatology Association (AADA) has been calling on its members to submit comment letters to the FDA in support of this proposal, which faces significant opposition from the indoor tanning industry. The AADA has developed a template letter for members to personalize and submit to the FDA before the Aug. 7, 2013, deadline. Contact Amanda Grimm at agrimm@aad.org for more information.

AADA condemns CMS proposal to cut graduate medical education
The Centers for Medicare and Medicaid Services (CMS) has issued a proposed rule that would cut graduate medical education (GME) in 2014. The American Academy of Dermatology Association (AADA) has sent a letter opposing the proposed rule — the Medicare Hospital Inpatient Prospective Payment Systems in 2014 — expressing concern that cuts to GME will exacerbate the dermatology workforce shortage and threaten patient access to dermatologic care. Specifically, the AADA opposed CMS’s recommendation to re-characterize days attributable to labor and delivery as inpatient days. Medicare’s share of the direct costs of medical education is determined by the ratio of Medicare inpatient days to total inpatient days, and this proposed change would reduce Medicare’s share of Direct GME costs and likely reduce the funding and availability of GME opportunities. Read the AADA’s letter of opposition. For more information, contact Richard Martin at rmartin@aad.org.

State policy roundup

Texas becomes fifth state to ban indoor tanning for minors under 18
Texas has joined California, Vermont, Oregon, and Nevada by passing legislation that prohibits minors under the age of 18 from indoor tanning. This legislation passed both the Texas Senate and House in May, and Gov. Rick Perry did not sign or veto the bill within the 20-day period. Therefore, the bill automatically became law on June 16. The ban will go into effect on Sept. 1, 2013. Read the American Academy of Dermatology Association’s (AADA) letters of support for the law’s originating bills, House Bill 598 and Senate Bill 329. Read the press release issued by the AADA. For more information, contact Kersten Burns at kburns@aad.org.

Illinois and Pennsylvania inch closer to instituting stricter indoor tanning restrictions
Illinois Gov. Patrick Quinn has less than 60 days to sign or veto legislation that would ban minors under the age of 18 from indoor tanning, before it automatically becomes state law. Similar legislation in Chicago and Springfield passed in 2012, and the Governor is expected to sign the state ban. Read the American Academy of Dermatology Association’s (AADA) letters of support for this ban.

In Pennsylvania, legislation which would prohibit minors 16 years old and younger from using indoor tanning devices, and would require in-person, written consent for 17-year-old minors, has passed the House and will be considered in the Senate. Read the AADA and Pennsylvania Academy of Dermatology and Dermatologic Surgery’s letter of support. For more information, contact Kersten Burns at kburns@aad.org.

Maine prohibits false, misleading advertising for health care services
Maine Gov. Paul LePage has signed legislation that would require health care practitioners who advertise their health care services to disclose the applicable license under which they are authorized to provide those services. Additionally, the legislation prohibits health care practitioners from including false or misleading information in advertisements for their health care services. The American Academy of Dermatology Association supported this legislation and similar rules that ensure that patients are clearly informed about who is providing their medical care. Read more about truth in advertising. For more information, contact Kersten Burns at kburns@aad.org.

New York legislation allowing dentists to perform surgery moves forward
New York Senate Bill 1918, which would allow dentists to perform surgical procedures involving the hard or soft tissues of the oral and maxillofacial area, has passed the Senate and will now be considered by the Assembly. The American Academy of Dermatology Association (AADA) is opposing this inappropriate scope-of-practice expansion, arguing that the legislation disregards adequate and appropriate medical training, and jeopardizes patient safety. Read the AADA's letters of opposition to the New York Senate and the New York Assembly. For more information, contact Lisa Albany at lalbany@aad.org.

Federal court decision could affect future scope-of-practice issues
The 4th Circuit Court of Appeals rejected an appeal by the North Carolina Board of Dental Examiners who challenged a Federal Trade Commission (FTC) decision that had found the dental board to have unlawfully restrained trade by issuing cease and desist letters to providers of teeth-whitening services not licensed as dentists. The court held that the state action doctrine — which exempts the activities of state agencies, such as a professional licensing board, from federal antitrust scrutiny — did not apply. The recent encroachment of the FTC into state scope-of-practice issues has had a chilling effect on state medical boards that are considering this issue with other specialties. The court’s decision could cause other boards to reconsider whether it will take a position on scope-of-practice concerns. Read a copy of the court’s opinion. For more information about dermatology scope-of-practice issues, contact Lisa Albany at lalbany@aad.org.

Dermatology state societies: Apply today for a State Advocacy Grant
State societies looking to fund advocacy activities to influence legislation and/or regulatory initiatives in 2014 are encouraged to apply for financial assistance through the American Academy of Dermatology Association’s (AADA) State Advocacy Grant Program. The AADA is offering this program for state dermatology societies to help advance key state health policy initiatives. Applications are due Sept. 30. Visit the AADA State Advocacy Grant program Web page to learn more. For more information, contact Kersten Burns at kburns@aad.org.

Upcoming events

Gov. Michael Leavitt to headline AADA Legislative Conference
Gov. Michael Leavitt, former governor of Utah and secretary of the U.S. Department of Health and Human Services, will discuss the future of health care reform during the keynote address at the American Academy of Dermatology Association’s 2013 Legislative Conference on Sept. 8-10, in Washington, D.C. This conference offers participants 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. Visit the conference Web page to view a preliminary agenda for the conference, and to register for this premier event. For more information, contact Blake McDonald at bmcdonald@aad.org.


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