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This week’s headlines:
Congressional action

New Congressional Skin Cancer Caucus will raise awareness, address rising incidence of skin cancer
A Congressional Skin Cancer Caucus, that includes co-Chairs Reps. Jim Cooper (D-Tenn.), Carolyn Maloney (D-N.Y.), Peter Roskam (R-Ill.), and Charlie Dent (R-Pa.), was recently formed to focus on addressing the growing rate of skin cancer among Americans. The caucus was established through a collaborative effort led by Rep. Cooper and the American College of Mohs Surgery, with support from the American Academy of Dermatology Association. This new bipartisan Congressional Member Organization will serve as a forum and resource for members of Congress working on this issue, and will support legislative activities and public policies that raise awareness about skin cancer, foster effective skin cancer prevention outreach and education, increase screening and early detection of skin cancer, and improve access to skin cancer care and treatment. Read the press release about the Congressional Skin Cancer Caucus. For more information, contact Christine O’Connor at coconnor@aad.org.

AADA responds to latest Medicare proposal
Determined to find a solution to the flawed Medicare physician payment formula, the American Academy of Dermatology Association (AADA) has responded to another request from the House Energy and Commerce Committee regarding its latest draft legislation that would repeal the flawed Medicare physician payment system. The AADA has responded to questions and proposals from Capitol Hill on five separate occasions, and is calling on Congress to replace the formula with a new reimbursement system that recognizes the rising costs of medical practice and promotes efforts to improve quality of care. Medicare payments are expected to face an estimated 24 percent cut on Jan. 1, 2014. 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.

Additionally, on July 10, the AADA attended a Senate Finance Committee hearing titled “Repealing the SGR and the Path Forward: A View from CMS” which heard testimony from Jonathan Blum, the Acting Principal Deputy Administrator and Director, Center for Medicare, Centers for Medicare and Medicaid Services, regarding CMS input on efforts to repeal Medicare’s flawed sustainable growth rate formula. More information regarding the Senate Finance Committee hearing is available on the Finance Committee website. For more information, contact Whitney Tyler at wtyler@aad.org.

Representatives express support for physicians to provide in-office services, oppose repeal proposals
As talks continue on how to strengthen Medicare and reform Medicare physician payments, the American Academy of Dermatology Association (AADA) and other physician groups have continued to advocate to preserve physicians’ ability to provide in-office ancillary services, including pathology, radiation therapy and other health care services. A coalition of 17 members of Congress, led by Rep. Phil Roe, MD (R-Tenn.) sent a letter calling on Speaker of the House Rep. John Boehner (R-Ohio) and Rep. Nancy Pelosi (D-Calif.) to preserve physicians’ abilities to provide in-office ancillary services such as pathology. President Obama’s budget proposes to repeal this provision for radiation therapy, advanced imaging, and physical therapy. In the letter, these representatives — who serve as physicians and other health providers prior to working in Congress — argued that limiting these services would present significant treatment barriers for patients and would increase the cost of health care for patients as well. Read the letter from Rep. Roe and his colleagues. For more information, contact Whitney Tyler at wtyler@aad.org.

Federal agency focus

Medicare announces proposed fee schedule rule for 2014
The Centers for Medicare and Medicaid Services (CMS) released the proposed rule for the 2014 Medicare Physician Fee schedule online on July 8. CMS estimates that dermatology as a specialty will see a 2 percent drop in payments, based on the programmatic changes that they are proposing to practice expense calculations. Additionally, the rule included a list of codes identified by Medicare contractor medical directors as potentially misvalued, including the codes for the first stage of Mohs surgery on the head and neck and on the trunk and extremities, 17311 and 17313.

The rule also proposed updates to the Physician Quality Reporting System — raising the number of measures that providers must report on from three to nine, but lowered the reporting threshold from 80 to 50 percent. CMS also proposed the addition of two dermatology-related measures regarding atopic dermatitis as well as psoriasis — bringing the total number of dermatology-related measures to six for the 2014 reporting year. Read more about the proposed rule.

The American Academy of Dermatology Association (AADA) is currently reviewing the proposed fee schedule and will be working in partnership with the other dermatologic societies to develop an appropriate strategy for addressing this proposed rule. Please continue to read this publication and to look for email and other updates that will be provided to the membership. In addition, we will continue to post information to the AADA website. The AADA will issue comments to CMS prior to the Sept. 6 deadline. As in previous years, final code values will appear in the final fee schedule rule in November. For more information, contact Richard Martin at rmartin@aad.org.

AADA meets with CMS on concerns about 2013 Medicare Physician Fee Schedule
Last month, the American Academy of Dermatology Association (AADA) met with officials at the Centers for Medicare and Medicaid Services (CMS) to follow up on concerns raised in the AADA’s official comment letter about the 2013 Medicare Physician Fee Schedule. The AADA is concerned that CMS rejected the RUC recommended work values and practice expense for a number of the shave lesion codes, complex repair codes, laser skin treatment codes and surgical pathology codes (11302, 11306, 11310-11313, 13152, 88305 and 96920-96922).The AADA appreciated the opportunity to raise questions regarding the relativity of CMS’ interim work values for these codes as well as the rationale for rejecting some of the supplies. The AADA urged CMS to uphold the RUC recommendations for these codes when they are finalized in the Final Rule for 2014, which is anticipated to be released in the beginning of November. For more information, contact Leslie Stein Lloyd at lsteinlloyd@aad.org.

MedPAC report recommends eliminating floor on geographic practice cost index
The June 2013 report from the Medicare Payment Advisory Commission (MedPAC) recommended that the Centers for Medicare and Medicaid Services (CMS) eliminate the “floor” on the geographic practice cost index (GPCI) for the work component of the Resource Value Units (RVUs). In doing so, this would allow fees to decline slightly in geographic areas where salaries are generally low. MedPAC also suggested that CMS look for a better way to calculate the work RVU GPCI. Read more about the June MedPAC report. For more information, contact James Scroggs at jscroggs@aad.org.

Dermatologists rally with more than 270 letters in support of tanning device reclassification
With less than a month to go before the official comment period closes, dermatologists have sent more than 270 letters to the U.S. Food and Drug Administration (FDA) in support of the agency’s recent proposal to strengthen regulations on 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.

Anticipating significant opposition from the indoor tanning industry, 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. 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.

State policy roundup

Connecticut governor considers tighter regulations for medical spas
Connecticut Governor Dannel Malloy has less than two weeks to sign or veto legislation that would require that all cosmetic medical procedures be performed by a physician — or an advanced practice registered nurse, physician assistant or registered nurse under a physician’s supervision — at any facility called a medical spa, medspa, or medispa. Senate Bill 1067 would also require a physician to serve as the facility’s medical director. A physician would also perform an initial physical assessment of each person prior to such procedure being performed. The American Academy of Dermatology Association, along with several state and national organizations, support this legislation. If Gov. Malloy does not sign or veto the bill before the deadline, it will automatically become law and will go into effect on Oct. 1. For more information, contact Lisa Albany at lalbany@aad.org.

Summer Academy Meeting session highlight: Indoor tanning legislation tips and tactics
While the American Academy of Dermatology Association (AADA), its members and state dermatology societies have been successful in advocating for stricter regulations on indoor tanning, the indoor tanning industry’s arguments have become increasingly aggressive. Don’t miss “Protecting America’s Youth: Responding to Tanning Industry Arguments and Advance Effective Policies” with Bruce A. Brod, MD, chair of the AADA State Policy Committee, at the 2013 Summer Academy Meeting on Saturday, Aug. 2 at 10 a.m. in the Sutton South room, and find out how you can advance effective policies on indoor tanning, and respond to the tanning industry’s arguments. View the preliminary program and register for the 2013 Summer Annual Meeting. For more information, contact Lisa Albany at lalbany@aad.org.

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

Advocate for dermatology on Capitol Hill: Attend the AADA Legislative Conference
Participants at the American Academy of Dermatology Association’s (AADA) Legislative Conference have the opportunity to learn from leading industry experts about the most-pressing issues facing the specialty and its patients. Conference attendees also get the hands-on, personalized training they need to become successful advocates for dermatology on Capitol Hill. Register today for the AADA’s 2013 Legislative Conference, held on Sept. 8-10, in Washington, D.C., and don’t miss this unique opportunity to 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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