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This week’s headlines:
Congressional action

New proposal repeals broken Medicare payment formula but concerns remain
A new legislative proposal to reform the Medicare physician payment system would replace the sustainable growth rate (SGR) formula with a system focused on quality incentives and developing alternative payment models. However, it also 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 American Academy of Dermatology Association (AADA) has carefully considered this proposal and issued a response to the Senate Finance Committee and the House Ways and Means Committee reiterating its support for permanent repeal of the SGR and adding stability to the system, but in a reasonable manner that acknowledges and accounts for rising practice costs. Without congressional action, a 24 percent across-the-board cut will go into effect on Jan. 1, 2014. The other option is for Congress to adopt a short-term patch to stop the cuts from occurring as it has done on 15 separate occasions over the past decade. The AADA is calling on all members to log on to the AADA Dermatology Advocacy Network and submit a letter urging Congress to repeal the SGR. For more information, contact Shawn Friesen at sfriesen@aad.org.

Tell Congress to oppose legislation limiting pathology services
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 strongly oppose legislation that would limit dermatologists’ ability to provide pathology services to their patients. The Promoting Integrity in Medicare Act of 2013 (PIMA), which was introduced in August, 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. 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. 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), as a member of the One Voice Against Cancer (OVAC) coalition, has issued a letter urging members of Congress to end the sequestration and increase medical research funding at the National Institutes of Health (NIH). Under sequestration, the NIH budget was cut by more than $1.5 billion in fiscal year 2013, including more than $250 million in cuts to cancer research funding. Read the OVAC letter. 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.

Flexible Spending Accounts could be used to cover over-the-counter drugs
Sens. Pat Roberts (R-Kan.) and Mary Landrieu (D-La.) have introduced legislation that would allow for Flexible Spending Accounts (FSAs) to be used to cover over-the-counter (OTC) drugs. The Restoring Access to Medication Act (S. 1647) would eliminate restrictions that were placed on tax-preferred accounts that prohibit their use for purchasing OTC medications without a prescription. The American Academy of Dermatology Association (AADA) has signed on to a Health Choices Coalition letter applauding the legislation for improving access in the health care system. Read the coalition letter. For more information, contact Shawn Friesen at sfriesen@aad.org.

Federal agency focus

Release of CMS Medicare Physician Fee Schedule delayed
Due to delays attributed to the government shutdown, the Centers for Medicare and Medicaid Services (CMS) has indicated that the 2014 Medicare Physician Fee Schedule final rule could be issued as early as Nov. 22. The American Academy of Dermatology Association (AADA) has anticipated the release of this rule and is prepared to provide members with rapid, up-to-date information as it becomes available. Members will receive a Member Alert email shortly after the schedule is released with topline analysis provided by AADA staff and member physicians on the overall effect of the rule on dermatology, the top codes with changes, and the 2014 Conversion Factor. Following the Member Alert, be on the lookout for a special edition of Dermatology Advocate with more in-depth analysis and AADA next steps, as soon as all dermatology-related codes are analyzed. More information and regular updates will also be posted to the AAD website. For questions or concerns, contact ppm1@aad.org.

State policy roundup

Oregon Medical Board reduces burdensome requirements of office-based surgery regulations
The Oregon Medical Board has adopted amendments to its office-based surgery regulations that, thanks to advocacy efforts by the American Academy of Dermatology Association (AADA) and the Oregon Dermatology Association (ODA), will not impede patient access to surgeries performed with Level 1 anesthesia (i.e. local, topical). The ODA and AADA submitted joint comments articulating their concerns to the board’s extremely burdensome proposal. Additionally, throughout the year, ODA members testified several times against the proposal, arguing that the proposed rules would exceed what is appropriate according to the level of anesthesia, and that the proposal as originally stated was neither consistent with widely recognized principles for office-based surgery, nor did it represent appropriate standards of care. The final proposal established 500 cubic centimeters of supernatant (ccs) fat as the threshold for mandatory office accreditation (as opposed to its proposed 100 ccs); excludes minor Level 1 procedures limited to the skin and mucosa from the written consent requirements; and requires basic life support for each licensee (physician, physician assistant) rather than every employee in the office with direct patient contact, as originally proposed. 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. The AADA will also be contacting the offices of all U.S. senators and representatives to make them aware of this opportunity. 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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