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This week’s headlines:

Congressional action

Supreme Court upholds health reform law
The Supreme Court yesterday upheld, by a 5-4 vote, the constitutionality of the 2010 health system reform law, the Patient Protection and Affordable Care Act (ACA), including the individual mandate that requires all Americans to purchase health insurance. The decision comes after two years of intense political debate following passage of the sweeping bill. The AADA released a statement immediately following the court’s decision and pledged to continue to advocate for needed changes that were not addressed in the health reform law. Please visit the AADA’s Health System Reform Resource Center for information on the ACA and the AADA’s actions beginning with its adoption and throughout the various stages of implementation.

Congress passes FDA user fee bill
On June 20, the House accepted changes to S. 3187, the reauthorization of the Food and Drug Administration’s (FDA) user fee program for drug and medical-device approval. On June 26, the Senate cleared the legislation as well. After weeks of negotiations, both chambers agreed on compromise language which the Congressional Budget Office estimates will reduce the deficit by $311 million over the next 10 years. The bill, which contains language from both the House and Senate, included provisions to help prevent drug shortages. It shortens the timeline for the FDA to make administrative decisions and — in an effort to bring cheaper generic drugs to the market sooner — sets a deadline of 270 days to respond to petitions for generic drug approval. In addition, the Secretary of Health and Human Services must maintain a publicly available list of drugs experiencing a shortage. Incentives are included for the development of antibiotics used to treat serious conditions. The President is expected to sign the legislation into law in the coming days.

Federal agency focus

FDA to institute new iPLEDGE non-compliance policy
Effective July 16, 2012, the iPLEDGE program will institute a new iPLEDGE non-compliance policy. This policy was approved as a component of the Isotretinoin Risk Evaluation and Mitigation Strategy (REMS), and sets forth the principles on which non-compliance by iPLEDGE stakeholders will be evaluated. The policy consists of tiered levels based on severity and/or accumulation of non-compliance complaints. The tiers include:

  1. Notice of Non-Compliance – Issued to a stakeholder for an action that demonstrates a lack of understanding of the program and requires stakeholders to be re-educated on the program requirements.
  2. Warning – Issued to a stakeholder who fails to comply with one or more fundamental elements of the risk program and requires stakeholders to comply with all corrective actions required by the Isotretinoin Product Manufacturers Group (IPMG).
  3. Permanent Deactivation – Stakeholders are permanently removed from the program and will not be allowed to prescribe isotretinoin to existing or future patients; no corrective action can be taken.

The complete Non-Compliance Action Policy is posted on the iPLEDGE website and available on the AAD's Web page about iPLEDGE.

Private payer activity

Horizon Blue Cross Blue Shield of New Jersey requires hospital privileges, board certification
Horizon Blue Cross Blue Shield of New Jersey notified its network physicians on May 29 that they must maintain board certification in their specialty and have active, unrestricted hospital privileges at a Horizon network hospital, where applicable to their specialty. The deadline for obtaining board certification is April 1, 2013. The AADA is collaborating in an effort, led by the Medical Society of New Jersey, to further clarify and address this issue. The AADA will continue to work on behalf of dermatology and provide an update as soon as possible.

Blue Cross Blue Shield Association changes claims filing process for laboratories
Blue Cross Blue Shield Association (BCBSA) changed its claims filing process for independent clinical laboratories, Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) providers, and specialty pharmacies. Prior to this policy change, a health care provider would file claims for BCBSA patients to the local plan. The new policy requires billing for lab services to go to the plan in the state in which the specimen was drawn. The AADA is actively addressing this policy change, working with the College of American Pathologists (CAP) and BCBSA to find a resolution.

State policy roundup

States make big moves to tighten tanning regulation for teens
On June 26, Rhode Island’s bill prohibiting minors from using indoor tanning beds without parental consent or a doctor’s note became law. The AADA commended the Rhode Island legislature for its commitment to reducing skin cancer in their state. Several other states have similar legislation pending, including New York and Massachusetts.

On June 25, AADA sent a letter to New York Gov. Andrew M. Cuomo urging him to sign AB 1074, which would prohibit minors 16 years old and younger from using indoor tanning beds and would require in-person parental consent for those between the ages of 17 and 18. The Massachusetts bill is currently awaiting legislative action. Members in Massachusetts can help move this bill forward by visiting the AADA’s Dermatology Advocacy Network (DAN) website today and sharing their support for increased skin cancer prevention with their state legislators.

Submit your 2013 AADA State Advocacy Grant applications
The AADA is now accepting applications for the 2013 state advocacy grant program. The program provides financial assistance to state dermatology societies for the advancement of their health policy initiatives. State societies applying for the grant must submit an application and all required supporting materials by Sept. 30, 2012. Learn more about the State Advocacy Grant Program and download your application today by visiting the State affairs Web page.

Upcoming events

Register now for the 2012 AADA Legislative Conference, Sept. 9 – 11, Washington, D.C.
The AADA is pleased to invite the entire Academy membership to register for the 2012 Legislative Conference, Sept. 9 – 11 at the Crystal Gateway Marriott, 10 minutes from the U.S. Capitol. The Legislative Conference is a unique blend of didactic and interactive advocacy training sessions, political debate, and the direct lobbying of your members of Congress. Conference attendees learn about critical health policy issues from national health policy experts, political insiders, and AADA advocacy leaders. A keynote address will be delivered by former CMS Administrator, Mark McClellan, MD, PhD. However, the most powerful aspect of the Legislative Conference is your ability to build and strengthen personal relationships with your members of Congress and their staff.

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