An important AADA advocacy priority is ensuring fair and accurate valuation of dermatologic services.
Health system reform: Key provisions under the Patient Protection and Affordable Care Act affect how the government values health care services, including establishment of an Independent Payment Advisory Board (IPAB), incentives for participation in the Physician Quality Reporting Initiatives (PQRI), and implementation of EHR and e-prescribing. The Academy is actively weighing in on the rulemaking process that will implement important provisions of the law.
The Academy's Health System Reform Resource Center is a comprehensive resource with information about the Patient Protection and Affordable Care Act and its effect on dermatology. Recent news includes:
2013 Medicare fee schedule
2012 Medicare fee schedule
Medicare administrative contractor and private sector payment issues
AADA opposes legislation that undermines physician-led RUC process: On April 6, 2011, the AADA joined several other physician specialty organizations in sending a letter to Speaker John Boehner regarding HR 1256, which Rep. Jim McDermott, MD, introduced. This bill would essentially undermine the current fair and equitable system of determining relative values for CPT codes by requiring outside contractors to reevaluate the Relative Value Scale Update Committee’s (RUC’s) work and identify what it determines to be misvalued codes.
Medicare Payment Advisory Commission: The Medicare Payment Advisory Commission (MedPAC) is an independent Congressional agency established to advise Congress about issues affecting Medicare. The AADA attends all MedPAC meetings and staff monitors and reports on the recommendations to Congress.
Topics include payments to private health plans participating in Medicare and providers in Medicare's traditional fee-for-service program, analyzing access to care, quality of care and other issues affecting Medicare. Two reports, issued each year in March and June respectively, are the primary outlets for Commission recommendations.
CMS issues final rule on Physician Payment Sunshine Act: The Centers for Medicare and Medicaid Services (CMS) released the final rule on the Physician Payment Sunshine Act, which would require manufacturers of drugs, devices, biologicals, and medical supplies covered by Medicare, Medicaid, or the Children’s Health Insurance Program to report to CMS any payments or other transfers of value they make to physicians and teaching hospitals.
Officially known as the "Transparency Reports and Reporting of Physician Ownership or Investment Interests," the Sunshine Act was implemented as part of the 2010 Affordable Care Act in an effort to increase transparency and reduce the likelihood of conflicts of interest between physicians and drug and medical device manufacturers.
Manufacturers will be required to initiate data collection starting Aug. 1, 2013. Information collected from Aug. 1 through Dec. 31, 2013, must be reported to CMS by March 31, 2014. CMS will release the data on a public website by Sept. 30, 2014.
In February 2012, the American Academy of Dermatology Association (AADA) submitted comments on the proposed rule, urging CMS to allow physicians to review reports prior to submission and to consider integrating third-party reviews with regard to these reports. The AADA also signed on to a letter from the American Medical Association expanding on the AADA’s concerns regarding the burden of compliance on physicians and the additional requirements in the proposed rule that were not called for in the health reform legislation.
Notably, in response to comments from the AADA and other organizations, CMS excluded the reporting of payments related to accredited continuing medical education activities that meet the definition of indirect payments in the final rule.