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This week’s headlines:
President's Alert

AADA President addresses impending challenges facing the specialty
At the 2013 Summer Academy Meeting in New York, members of the American Academy of Dermatology Association (AADA) Council on Government Affairs, Health Policy, and Practice and Academy leadership met to discuss the multiple threats facing dermatologic practice, including severe cuts in reimbursement for specific services and potential limits on office-based dermatologic care. In response to this discussion, AAD President Dirk M. Elston, MD, issued a special President’s Alert to the full AAD membership that addressed the effects of the changing health care environment on the dermatologic specialty, and called on members to take action, including scrutinizing their own practice patterns. Read more from the President’s Alert. The AADA takes these challenges very seriously and will take steps to advocate to policymakers and AAD members to ensure the viability of dermatology in the future. Look for more on the issues raised in the President’s Alert in upcoming issues of Dermatology World and Member to Member. For more information, contact govtaffairs@aad.org.

Congressional action

AADA battles legislation that would limit ability to provide pathology services
The American Academy of Dermatology Association (AADA), joined by the American Medical Association and more than 30 specialty groups, sent a letter opposing 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. Read the joint letter, from the AADA and other specialty groups, that was sent to all of the members of the U.S. House of Representatives. 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 – without the preceding zeros – and birth date to login.) For more information, contact Christine O’Connor at coconnor@aad.org.

AADA Board of Directors approves position statement on Graduate Medical Education funding
In an effort to address the U.S. physician workforce shortage, the American Academy of Dermatology (AAD) and the AAD Association (AADA) Board of Directors approved a position statement on Graduate Medical Education (GME) funding at the 2013 Summer Academy Meeting in New York. GME financing continues to be of concern as Congress looks for cost savings in the Medicare program. The position states that the AADA supports an increase in Medicare-funded GME positions, and calls on Congress to remove the freeze on Medicare-supported residency positions that has been in effect since 1997. Read the AAD/A’s position statement on GME. For more information, contact Whitney Tyler at wtyler@aad.org.

AADA hosts Congresswoman Duckworth for roundtable discussion on health care reform
The American Academy of Dermatology Association (AADA) hosted Rep. Tammy Duckworth (D-Ill.) at its Schaumburg, Ill. headquarters for a roundtable discussion on health care reform and other issues affecting various medical specialties. Executives and physicians representing several medical associations joined the AADA and participated in an interactive discussion with the Congresswoman. Rep. Duckworth is a member of the House Oversight and Government Reform Committee with a special assignment on health care. For more information, contact Katie Jones at kjones@aad.org.

Updated Dermatology Advocacy Network layout requires new login information
The American Academy of Dermatology Association (AADA) Dermatology Advocacy Network (DAN) Web page has been updated to provide greater ease of use and navigation for members. The updated layout will require members to log in using the member’s ID without the preceding zeros, as well as the member’s birth date. Log on to the DAN site and find out how your involvement in advocacy can make a difference. For more information, contact Blake McDonald at bmcdonald@aad.org.

Federal agency focus

CMS finalizes changes that will reduce Graduate Medical Education payments
Despite the advocacy efforts made by the American Academy of Dermatology Association (AADA) and other stakeholder groups, the Centers for Medicare and Medicaid Services (CMS) has finalized its FY2014 Inpatient Prospective Payment Systems rule to include labor and delivery days as inpatient days in the Medicare utilization calculation for direct Graduate Medical Education (GME) payments. Medicare’s share of the direct costs of medical education is determined by the ratio of Medicare inpatient days to total inpatient days; therefore CMS estimates that this modification will reduce direct GME payments by an estimated $19 million. In its proposed rule, CMS estimated the reduction would be only $15 million. The AADA sent a letter opposing the proposed rule expressing concern that cuts to GME will exacerbate the dermatology workforce shortage and threaten patient access to dermatologic care. In its response, CMS reasoned that “revising the ratio to include labor and delivery days is appropriate because they are inpatient days and therefore should be counted as such.” Read more about the final rule (page 919). For more information, contact Richard Martin at rmartin@aad.org.

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.

Specialty Compounding will recall sterile products after FDA warning
Specialty Compounding, LLC, will voluntarily recall its full line of sterile products used to inject drugs. The U.S. Food and Drug Administration (FDA) issued a voluntary recall on the company’s sterile products citing that 15 patients in Texas developed bacterial bloodstream infections after receiving calcium gluconate injections distributed by Specialty Compounding. The recall applies to any of the company’s sterile medication that has not reached its expiration date, and the FDA advises that physicians should quarantine and return these products to Specialty Compounding. Read more on the FDA’s website. For more information, contact Amanda Grimm at agrimm@aad.org.

FDA expects to issue proposed rule on new sunscreen ingredients in September
In response to prompting from several members of Congress calling on the U.S. Food and Drug Administration (FDA) to move forward in approving eight sunscreen ingredients, the FDA has stated that it expects to issue its approval decision on five of the eight ingredients in September. The eight ingredients under review are Amiloxate, Enzacamene, Octyl Triazone, Bemotrizinol, Bisoctrizole, Iscotrizinol, Ecamsule, and Drometrizole Trisiloxane; the FDA has not indicated which five ingredients will be ruled on. Since 2008, the FDA has indicated that the pending sunscreen ingredient applications are an agency priority. The American Academy of Dermatology Association looks forward to the FDA’s review of these ingredients, and will provide more updates as they become available. For more information, contact Amanda Grimm at agrimm@aad.org.

State policy roundup

Illinois becomes sixth state to ban indoor tanning for minors under 18
Illinois has joined Vermont, California, Oregon, Nevada, and Texas by passing legislation that prohibits minors under the age of 18 from indoor tanning. Following similar ordinances recently put in place in Springfield and Chicago, this legislation was introduced by Reps. Robin Gable and Raymond Poe earlier this year and passed both the Illinois Senate and House in May. Gov. Patrick Quinn signed the bill into law on Aug. 15 and the law will go into effect on Jan. 1, 2014. Read more about the Illinois ban on indoor tanning for minors. For more information, contact Lisa Albany at lalbany@aad.org.

AADA members provide skin cancer screenings at National Conference of State Legislatures
Members and staff of the American Academy of Dermatology Association (AADA) met with state legislators nationwide and their staff at the National Conference of State Legislatures’ 2013 Legislative Summit last week in Atlanta. The AADA members – Kendra Cole, MD; John Kayal, MD; Alexander Gross, MD; Rutledge Forney, MD; Lewis Collins, MD; Kathleen Smith, MD; and Diamondis Papadopoulos, MD — provided more than 100 skin cancer screenings to Summit attendees, and offered first-hand information about UV radiation exposure and indoor tanning. The AADA’s exhibit booth, Physicians Advocating for Patients, also included the American College of Surgeons, American Academy of Family Physicians, American Society of Anesthesiologists, and American Association of Orthopaedic Surgeons. The AADA advocates with state legislators and regulatory bodies on a variety of issues that affect the specialty and its patients. Learn more about the AADA activities at the state level. For more information, contact Lisa Albany at lalbany@aad.org.

Nebraska lawmakers seek to remove indoor tanning salon tax
The Nebraska Department of Revenue is proposing to repeal the requirement that gross receipts from the sale of admission to tanning salons are subject to the sales and use tax. The American Academy of Dermatology Association (AADA) and the Nebraska Dermatology Society (NDS) contend that repealing this tax would exceed the agency’s statutory authority and harm minors in Nebraska. Like state and federal taxes on tobacco, a sales and use tax on indoor tanning services appropriately reflects the carcinogenic effects of indoor tanning and serves as a deterrent to this harmful behavior. Read the AADA and NDS letter of opposition. 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 Lisa Albany at lalbany@aad.org.


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