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This week’s headlines:
Congressional action

House committee approves bill to repeal flawed Medicare physician payment formula
The House Energy and Commerce Committee has unanimously approved the Medicare Patient Access and Quality Improvement Act (HR 2810) which would repeal the flawed sustainable growth rate (SGR) formula and replace it with a system focused on quality incentives and the development of alternative payment models. The bill would replace the SGR with positive payment updates of 0.5 percent and create a five-year period of stability to allow for the testing of alternative payment models. The American Academy of Dermatology Association (AADA) has raised concerns about the administrative burdens that the legislation could create for physicians through a new Quality Update Incentive Program that would operate along with the Physician Quality Reporting System program. The AADA sent a letter to the Committee outlining the issues it supports as well as the issues of concern. Read the AADA letter to the House Energy and Commerce Committee. The AADA will continue to work with Congress to ensure that any new payment system recognizes multiple practice settings and does not impede patient access to high-quality, dermatologic care. For more information, contact Shawn Friesen at sfriesen@aad.org.

Legislation would limit ability to provide pathology services, AADA members urged to contact Congress
Rep. Jackie Speier (D-Calif.) — along with cosponsors Reps. Jim McDermott (D-Wash.), and Dina Titus (D-Nev.) — has introduced H.R. 2914, the Promoting Integrity in Medicare Act of 2013 (PIMA) that would eliminate the in-office ancillary services exception to the Stark Law, which allows physicians to provide patients advanced imaging, anatomic pathology, radiation therapy and physical therapy services within their offices. Currently, physicians are prohibited from self-referring Medicare patients for health care services in which they have a financial interest; however, in-office ancillary services are exempt from this rule. The American Academy of Dermatology Association (AADA) is working with other physician groups and health care providers to oppose this legislation which would hinder integrated and coordinated care for patients within a physician’s practice. Read the AADA’s position statement on pathology billing. The AADA encourages members to log on to the AADA Dermatology Advocacy Network (DAN) to contact their members of Congress to oppose this legislation. (New DAN layout requires member ID and birth date to login.) For more information, contact Christine O’Connor at coconnor@aad.org.

Members of the House and Senate support FDA proposed order on indoor tanning devices
Advocates for skin cancer prevention and education in the U.S. House and Senate have sent letters to the U.S. Food and Drug Administration (FDA) in support of the agency’s effort to reclassify tanning devices. See related story below. Congressional Skin Cancer Caucus co-chairs Reps. Carolyn Maloney (D-N.Y.) and Charlie Dent (R-Penn.), along with six members of the House, sent a letter to the FDA commending the agency for the proposed order. Sen. Jack Reed (D-R.I.) — and seven other senators — also praised the proposed order and called on the FDA to take the next step by restricting access to minors under the age of 18. In a separate letter, Sen. Johnny Isakson (R-Ga.) applauded the FDA’s actions to require labeling that educates consumers, and urged the agency to expedite the premarket notification process required for Class II medical devices. For more information, contact Christine O’Connor at coconnor@aad.org.

Federal agency focus

CDC, Office of Surgeon General take action on reducing UV exposure, skin cancer
Recognizing that exposure to ultraviolet (UV) radiation is associated with increased skin cancer risks, the Centers for Disease Control and Prevention (CDC) is requesting information from the public on strategies and barriers to prevent skin cancer through reduction of UV exposure. CDC will collect and provide the information to the Office of the Surgeon General where it is expected that Interim Surgeon General, dermatologist Boris Lushniak, MD, will identify opportunities for the government, public and private organizations, health care providers and individuals to raise awareness on sun-protection practices. Read the CDC Issues Notice. The American Academy of Dermatology Association (AADA) discussed this request with the CDC and is working closely with the AADA Regulatory Policy Committee to prepare the AADA's comments. The AADA is also collaborating with the Skin Cancer Foundation and the National Council on Skin Cancer Prevention. For more information, contact Amanda Grimm at agrimm@aad.org.

AADA applauds FDA on proposal to reclassify indoor tanning devices
The American Academy of Dermatology Association (AADA), along with about 10 partnering organizations, nearly 15 dermatologic state societies and several members of Congress have flooded the U.S. Food and Drug Administration (FDA) with comment letters supporting the agency’s proposal to reclassify tanning devices. Read the AADA comment letter. 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. More than 2,400 comments were submitted to the FDA. Only 633 comments have been posted to the public site, of which the majority is in support of the proposed order. The FDA will now review all of the comments; the AADA is hopeful that the agency will issue a final order in the near future. For more information, contact Amanda Grimm at agrimm@aad.org.

Academy urges White House to nominate dermatologist Boris Lushniak, MD, MPH, for Surgeon General
The American Academy of Dermatology (Academy), has written to President Obama urging him to nominate Rear Admiral Boris Lushniak, MD, MPH, a member of the American Academy of Dermatology, as the 19th Surgeon General of the United States. Dr. Lushniak has been serving as Interim Surgeon General since June when Regina Benjamin, MD, stepped down. The Academy has enjoyed a positive rapport with Dr. Lushniak — who is board certified in dermatology and preventative medicine — and firmly believes that his strong reputation as a champion of public health and preventative strategies, and an effective communicator makes him the most appropriate nominee. Read the Academy’s letter of support.

Financial data collection now required under Sunshine Act
As part of the National Physician Payment Transparency Program — also known as the Sunshine Act — as of Aug. 1, drug manufacturers and group purchasing organizations are now required to track and report payments to physicians and teaching hospitals to the Centers for Medicare and Medicaid Services (CMS). CMS will post the information that industry provides on the Open Payments public website, which anyone will be able to access on Sept. 30, 2014. Physicians do not have to submit this information to CMS; however they are advised to track payments they receive from industry for verification purposes. Learn more about Sunshine Act requirements and exemptions, as well as guidance on what physicians should do to track their payments. For more information, contact Richard Martin at rmartin@aad.org.

FDA restricts use of oral antifungal medication
The U.S Food and Drug Administration (FDA) is restricting the use of Nizoral (ketoconazole) oral tablets warning that the medication should not be prescribed as a first-line treatment for any fungal infection as it can cause severe liver injuries and adrenal gland problems. The FDA is asking that physicians refrain from prescribing ketoconazole tablets for any patients with underlying liver disease. Patients who are taking the drug should immediately begin weekly tests of alanine aminotransferase level testing to identify any liver damage. Read more from the FDA. For more information, contact Amanda Grimm at agrimm@aad.org.

FDA issues warning on skin diseases associated with acetaminophen use
The U.S. Food and Drug Administration (FDA) issued a warning that acetaminophen has been associated with the risk of developing skin diseases such as Stevens - Johnson syndrome, toxic epidermal necrolysis, and acute generalized exanthematous pustulosis. The FDA advises that physicians should be aware of this risk when evaluating patients. For more information, visit the FDA website, or contact Amanda Grimm at agrimm@aad.org.

State policy roundup

Ohio legislature considers telemedicine bill
The Ohio Dermatological Association (ODA) and the American Academy of Dermatology Association (AADA) submitted a joint comment letter in support of House Bill (HB) 123, which would require Medicaid to cover telemedicine services that are otherwise covered under the policy. The bill has passed the House and is being considered by the Senate. Read more about HB 123. Read the AADA and ODA letter of support. 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.

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