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This week’s headlines:
Congressional action

Committees release new Medicare payment reform proposal; Reps. call for action on SGR
With a 24 percent across-the-board Medicare rate cut looming, the Senate Finance Committee and the House Ways and Means Committee have released their joint bipartisan proposal to reform the Medicare physician payment system. The American Academy of Dermatology Association (AADA) is carefully considering this proposal, which in some respects follows the House Energy and Commerce Committee’s Medicare Patient Access and Quality Improvement Act (HR 2810) by replacing the sustainable growth rate (SGR) formula with a system focused on quality incentives and developing alternative payment models. However, this latest proposal includes a 10-year freeze on payment rates and other problematic provisions including one that would seek to cut payments for particular services that are identified as potentially being “misvalued.” This could impose a whole new round of payment cuts for some physician services and specialties. The AADA has consistently reiterated its support for permanent repeal of the SGR, and stability to the system, but in a reasonable manner that acknowledges and accounts for rising practice costs. U.S. Reps. Bill Flores (R-Texas) and Dan Maffei (D-N.Y.) are calling on Speaker of the House John Boehner (R-Ohio) and Minority Leader Nancy Pelosi (D-Calif.) with a “dear colleague” letter to seize upon the momentum this year to enact bipartisan reforms that permanently replace the SGR with a system that includes health care delivery reforms that drive quality and efficiency. The AADA urges its members to log on to the AADA Dermatology Advocacy Network to email their members of Congress encouraging them to sign on to Reps. Flores and Maffei’s letter. For more information, contact Shawn Friesen at sfriesen@aad.org.

House Doctors Caucus members raise concerns with CMS on Medicare Physician Fee Schedule changes
Due to prompting from the American Academy of Dermatology Association (AADA) and other physician organizations, 16 key members of the House of Representatives Doctors Caucus have written to the Centers for Medicare and Medicaid Services (CMS) expressing concerns about a provision in the proposed Medicare Physician Fee Schedule that would place a cap on non-facility (office-based) practice expense payment for 211 physician services at either hospital outpatient prospective payment system or ambulatory surgical center rates. In its proposal, CMS has indicated that it believes these physician services are misvalued. The proposal will reduce payments for many services by 50 percent or more, including phototherapy and other important services. This could potentially make these services unavailable in physicians’ offices, thereby denying patients access to services in a more convenient and less fragmented setting. In their letters, the members urged CMS to withdraw this provision in the 2014 Medicare Physician Fee Schedule proposed rule. Read the letter that the Doctors Caucus sent to CMS. For more information, contact Shawn Friesen at sfriesen@aad.org.

Take action: Oppose limits on pathology services
The Promoting Integrity in Medicare Act of 2013 (PIMA) would eliminate the exception to the Medicare Stark Law that allows physicians to provide advanced anatomic pathology, imaging, radiation therapy, and physical therapy services within their offices, and the American Academy of Dermatology Association (AADA) is mobilizing all members to log on to the AADA Dermatology Advocacy Network (DAN) to contact their members of Congress to oppose this legislation and preserve dermatologists’ ability to provide these important services to their patients. For more information, contact Christine O’Connor at coconnor@aad.org. For more information on how to get involved, or to share your congressional contacts, email grassroots@aad.org.

One Voice Against Cancer coalition calls for increased funding for life-saving cancer research
The American Academy of Dermatology Association (AADA) and 25 of its One Voice Against Cancer (OVAC) coalition partners held nearly 50 meetings on Capitol Hill last week urging members of Congress to end the sequestration and increase medical research funding at the National Institutes of Health. The AADA is calling on all members to log on to the AADA Dermatology Advocacy Network and submit a letter to members of Congress to end the sequester and support funding for cancer research and prevention. For more information, contact govtaffairs@aad.org.

AADA encourages Congress to share healthy skin resources with constituents
This November, as part of National Healthy Skin Month, the American Academy of Dermatology Association (AADA) is urging members of Congress and their staff to enhance their constituents’ knowledge about how to protect their skin 365 days a year. The AADA sent a letter to members of Congress offering resources on how to select a sunscreen, conduct a skin self-exam, and find a dermatologist. The AADA also urged members of Congress and their constituents to see a board-certified dermatologist for the proper diagnosis and treatment of skin conditions and other serious diseases. Find out more information on National Healthy Skin Month in the AAD Media Relations Toolkit. For more information, contact Victoria Houghton at vhoughton@aad.org.

Federal agency focus

FDA issues proposed rule on drug shortages
The U.S. Food and Drug Administration (FDA) has issued a proposed rule that will require all drug and biologics manufacturers to notify the FDA of any plans to halt production of a drug in short supply or any temporary disruption in manufacturing that may result in a drug shortage. Physicians across the country have expressed concern regarding the ongoing shortage of vital drug products. Drug shortages are affecting every medical specialty, including anesthesia, oncology, emergency medicine and dermatology. The American Academy of Dermatology Association (AADA) works with the FDA on a continuous basis to resolve drug shortage issues. The AADA will review the proposed rule on drug shortages and provide more information as it is available. For more information, contact Amanda Grimm at agrimm@aad.org.

State policy roundup

Deadline for individual enrollment in health insurance exchanges extended to March 31
The Obama Administration has announced that, due to technical difficulties, the deadline for individuals without health care to enroll in state-based health insurance exchanges has been extended to March 31. Previously, consumers were required to purchase coverage by Feb. 15 to avoid paying a penalty. As part of the Affordable Care Act, states are required to provide Health Insurance Marketplaces where individuals without health care and small businesses can compare and enroll in various health insurance options. Coverage for both individuals and small businesses will start on Jan. 1, 2014. Read about your state’s plan on the Centers for Medicare and Medicaid Services’ website. The American Academy of Dermatology Association has been monitoring this issue and will provide additional information as it learns more about the impact of these health insurance exchanges on the specialty. Read more in the Sept. 2012 issue of Dermatology World. For more information, contact govtaffairs@aad.org.

Virginia seeking public comments on indoor tanning regulations
The Virginia Joint Commission on Health Care (JCHC) has issued a report highlighting the dangers of indoor tanning and the incidence of skin cancer, and has suggested three potential policy options for the legislature’s consideration. The Commission is seeking comment from the public on whether to pursue one of the following options: taking no action; introducing legislation that prohibits minors under the age of 15 from using tanning devices at indoor tanning facilities, and requiring a parent or legal guardian of unemancipated persons 15 to 17 to provide written consent; or introducing legislation prohibiting unemancipated minors under the age of 18 from using indoor tanning devices at an indoor tanning facility. The American Academy of Dermatology Association will submit comments supporting the third option to ban indoor tanning for minors under the age of 18. Public comments are due Nov. 12. For more information, contact Lisa Albany at lalbany@aad.org.

AADA president-elect testifies at Ohio indoor tanning hearing
American Academy of Dermatology Association (AADA) President-Elect Brett Coldiron, MD, FAAD, testified before the Ohio Senate Commerce and Labor Committee this week in favor of stricter indoor tanning regulations proposed in Ohio. Senate Bill (SB) 113 would prohibit minors under 18 from using indoor tanning devices. The AADA sent a letter to the Ohio Senate Commerce and Labor Committee in support of this legislation. Read the letter of support for SB 113. For more information, contact Lisa Albany at lalbany@aad.org.

National Healthy Skin Month resources available
The American Academy of Dermatology Association (AADA) is assisting members and state dermatological societies in promoting November as National Healthy Skin Month as a way to establish or enhance relationships with policymakers. State societies and members are encouraged to contact their governors and mayors to seek a proclamation raising awareness about skin disease. Resources for members to discuss National Healthy Skin Month are available online in the AAD Media Relations Toolkit. Members and state societies who are interested in pursuing a mayoral or gubernatorial proclamation can contact Victoria Houghton for assistance at vhoughton@aad.org.


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