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This week’s headlines:

Congressional action

Senate Finance Committee holds roundtable forum to discuss Medicare payment reform
On July 11, the Senate Finance Committee held the third in a series of roundtable discussions on the need to reform the Medicare physician payment system and replace the flawed sustainable growth rate (SGR) formula. The Committee heard from various physician organizations, and several specialties testified on the need for reforming the SGR and developing new payment models. Several panelists highlighted the differences among the various physician specialties and stressed that any new payment models include flexibility that recognizes those differences and the variety in physician practices. The panelists also stated that a “one size fits all” approach would be detrimental to the goal of achieving quality, fiscally responsible health care. Without legislation enacted to replace the reduction, physician Medicare payments will be cut by 27 percent on Jan, 1, 2013, according to the just-released proposed 2013 Medicare Fee Schedule (see item below).

One Voice Against Cancer holds lobby day
AADA volunteers joined with groups from across the country to participate in the One Voice Against Cancer (OVAC) Lobby Day on July 10. Each year OVAC organizes advocates and volunteers to join forces and lobby Congress on the importance of cancer research and prevention funding. The AADA and OVAC continue to advocate throughout the year for funding of this important, life-saving scientific research.

House votes for second time to repeal the Affordable Care Act
Following the Supreme Court’s ruling upholding the Affordable Care Act, the House debated and voted on legislation to repeal it. It is the second time in the past two years that the House has voted to repeal President Obama’s health reform law. After two days of debate, the House passed the measure with a near party-line vote of 244-185. Five Democrats joined Republicans in voting to repeal. The legislation was largely symbolic and is not expected to see further action this year, as the Senate is not expected to consider it.

President Obama signs FDA bill into law
The bill reauthorizing the Food and Drug Administration’s (FDA) user fee program for drug and medical-device approval, S. 3187, was signed into law by President Obama on July 9. The bill focuses on accelerating the drug approval process under the FDA by setting decision timelines and requires the Secretary of Health and Human Services to maintain a publicly available list of drug shortages. The bill was negotiated for several weeks and easily passed both chambers of Congress last month.

Get involved: AADA offers new tools for the 2012 election
With the 2012 elections just a few short months away, the AADA has posted a set of tools and questions to help you identify opportunities to meet with both your elected representatives and with candidates for office in your states and communities. In August, key decision-makers will be holding campaign events such as town hall meetings, rallies, and get-out-the-vote drives. These are excellent opportunities to ask the candidates how they intend to support the specialty of dermatology, your practice, and your patients.

Federal agency focus

Proposed 2013 Medicare fee schedule rule estimates physician payment cuts
In its recently released proposed rule for the 2013 Medicare fee schedule, the Centers for Medicare and Medicaid Services (CMS) estimates that without congressional action, the sustainable growth rate (SGR) will cut payments to physicians overall by 27 percent. Assuming Congress passes a "fix," CMS estimates that dermatology will see a 1 percent drop in payments, faring better than many other non-primary-care specialties due to the implementation of the fourth year of a four-year transition to new practice expense relative value units (P/E RVUs) developed using the Physician Practice Information Survey. The transition, culminating in 2013, has gradually increased the non-facility P/E RVUs for most of the dermatology codes since the transition began in 2010. CMS did not release the physician work RVU values with the proposed rule, so the anticipated payment amounts for 2013 will not be available until November. However, the rule contains proposed updates to the Physician Quality Reporting System (PQRS), including three dermatology-specific measures related to melanoma and biopsy-related care coordination. The AADA is analyzing the proposed rule and will provide timely updates to members. The AADA continues to advocate for a permanent solution to the SGR.

CMS releases proposed rule for ambulatory surgery quality reporting, comments due Sept. 4
The Centers for Medicare and Medicaid Services (CMS) recently published a proposed rule that would create a “sub-regulatory” process for quality reporting by ambulatory surgical centers (ASCs) similar to its quality reporting system for hospital outpatient facilities. The rule also makes a number of proposals relating to Quality Improvement Organizations (QIOs). QIOs, formerly known as Peer Review Organizations, are private contractors that work for CMS to review the appropriateness, effectiveness, and quality of care provided to Medicare beneficiaries. Overall, the rule governs the 2013 Hospital Outpatient Prospective and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs and QIOs. This proposed rule is relevant to dermatologists who provide care in ASCs, or same-day surgery centers, rather than performing office-based surgery. AADA staff is reviewing the rule in more detail and will provide an update shortly.

Private payer activity

Academy suggests improvements to draft specialty practice recognition standards
The Academy recommended to the National Committee for Quality Assurance (NCQA) that it consider ways to better tailor its proposed Specialty Practice Recognition 2013 standards to meet the needs of small group and solo physician specialty practices. The NCQA developed the draft standards for specialty practices that would want to be considered for patient-centered medical homes (PCMH). Public comments on the draft rule are due by July 13. The Academy expressed concerns that the draft Specialty Practice Recognition standards prematurely incorporate the CMS Stage 2 Meaningful Use (MU) Criteria, which have not yet been adopted. Additionally, the Academy recommended that NCQA provide practical support for solo practices which want to participate in patient-centered medical homes.

State policy roundup

California patient safety bill goes to Gov. Brown
On July 2, the California State Assembly unanimously passed Assembly Bill 1548, which is cosponsored by the American Society for Dermatologic Surgery Association (ASDSA) and the California Society of Dermatology and Dermatologic Surgery (CalDerm). The bill was then sent to Gov. Jerry Brown, who has 30 days to sign or veto the legislation. If Gov. Brown does not take action after the 30 days, the bill will be enacted without his signature. The AADA shared its support for the legislation with Gov. Brown via written comments. AB 1548 is aimed at improving patient safety in corporate-owned medical spas, which often lack physician supervision and oversight. Learn more about this issue in the AADA’s State Advocacy Toolkit.

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, such as Medicare physician payment and health system reform, 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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