Advocacy news briefing

advocacy news banner1

AMA HOD adopts modifier 25 resolution

November 14, 2017

The American Medical Association (AMA) House of Delegates (HOD) has adopted a resolution that was authored by the American Academy of Dermatology delegation and Dermatology Section Council (DSC) to address insurers’ attempts to reduce reimbursement for modifier 25. The resolution, triggered by recent announcements that Anthem Blue Cross Blue Shield and Independence Blue Cross will reduce reimbursement for modifier 25 in several states, calls on the AMA to aggressively and immediately advocate through any legal means to see that insurers comply with accepted CPT coding and reimbursement guidelines.

Furthermore, the AMA President and AMA Board Chair met with the DSC to address the AADA's concerns, and stated that they would act aggressively in opposition to these types of policies.

Final language of the resolution:

RESOLVED: That our American Medical Association aggressively and immediately advocate through any legal means possible, including direct payer negotiations, regulations, legislation, or litigation, to ensure when an evaluation and management (E&M) code is appropriately reported with a modifier 25, that both the procedure and E&M codes are paid at the non-reduced, allowable payment rate.

Additionally, the AADA and state dermatologic societies sent a letter to the Blue Cross Blue Shield Association (BCBSA) highlighting concerns with BCBSA member plans' proposals to reduce reimbursement for modifier 25 in several states effective January 1, 2018. To read the letter, click here.


AADA, state derm societies fight modifier 25 policy change with BCBSA, at AMA

November 13, 2017

The American Academy of Dermatology Association (AADA) and state dermatologic societies today sent a letter to the Blue Cross Blue Shield Association (BCBSA) highlighting concerns with BCBSA member plans' proposal to reduce reimbursement for modifier 25 in several states effective January 1, 2018. To read the letter, click here.

Additionally, the American Medical Association (AMA) House of Delegates will be voting on a resolution that addresses insurers' attempts to reduce reimbursement for modifier 25. The AADA has led the efforts in drafting the resolution, which calls on the AMA to urge insurers to comply with accepted CPT coding and reimbursement guidelines.

The Academy has developed a number of resources for members on appropriate usage and documentation of modifier 25. To sign up for updates on modifier 25 advocacy efforts, fill out the form here.


2018 Medicare physician fee schedule & Quality Payment Program/MACRA rules out today, House passes IPAB repeal

November 2, 2017 

The Centers for Medicare and Medicaid Services (CMS) today released the 2018 Medicare Physician Fee Schedule rule as well as the final rule for the 2018 Quality Payment Program (QPP), established under the Medicare Access and CHIP Reauthorization Act (MACRA). CMS indicates these rules reflect the agency’s broader strategy of relieving regulatory burdens for providers, particularly for small and solo practices. Additionally, the U.S. House of Representatives today passed legislation repealing the Independent Payment Advisory Board (IPAB), which would be charged with making significant cuts to Medicare when government spending on the program reaches a certain threshold. Much of what is being announced today reflects wins for the Academy, and is a result of the AADA’s regulatory relief priority and advocacy over the past 10 months.

Read the AADA breaking news alert with more information. While the House today passed legislation repealing IPAB, it is unclear whether the Senate will also act. Send a letter to your Senators in favor of IPAB repeal through the AADA’s Advocacy Action Center.


AADA fights modifier 25 policy change

October 27, 2017

The American Academy of Dermatology (AADA) is concerned about payers' policy to reduce reimbursement for modifier 25, and is working closely with state dermatology societies and other medical specialty societies in an effort to reverse this policy. Today the AADA held a conference call with Anthem Blue Cross Blue Shield, which will be reducing reimbursement for modifier 25 in California, Connecticut, Kentucky, Maine, Nevada, New Hampshire, Ohio, and Wisconsin starting with claims processed on or after Jan. 1. The AADA expressed its concerns that the policy contradicts well-accepted coding conventions and guidelines, and also issued a letter to Anthem in conjunction state dermatology societies further explaining that the policy is an inappropriate reduction of modifier 25 and should be reconsidered.

The AADA will continue fighting this policy change. To sign up for updates on modifier 25 advocacy efforts, fill out the form here.


AADA supports federal bill on truth in advertising

October 23, 2017

U.S. Representatives Larry Bucshon, MD (R-Ind.), a thoracic surgeon, and David Scott (D-Ga.) recently introduced the Truth in Healthcare Marketing Act (H.R. 3928). This bipartisan consumer protection bill will help ensure patients have reliable information regarding the delivery of their medical care, empowering them to make medical decisions that are best for themselves and their families. To read the AADA's letter supporting this legislation, click here.
 
In addition to fighting for truth in advertising and strengthened scope of practice regulations, the Academy has developed resources for members to get involved. Find out more on our Truth in Advertising and Scope of Practice pages, including how you can submit an issue of concern to the Academy.


Academy comments on proposed ’18 Fee Schedule

September 7, 2017

The AADA has submitted to the Centers for Medicare & Medicaid Services (CMS) its comments on the proposed 2018 Medicare Physician Fee Schedule, which was released in July.  In its comments letter, the AADA requests a number of technical changes to the proposed valuation of specific codes, recommends that CMS accept RVU Update Committee (RUC)-recommended times and RVUs, and expresses concern regarding prior authorization requirements, drug pricing, and modifier 25 payment reduction policies.  The AADA also indicates its full support of CMS’ proposal to reduce the Physician Quality Reporting System (PQRS) requirements of 6 measures down from the current program policy of 9 measures.  In addition, the AADA appreciates that CMS proposed to accept our recommendation to reduce the maximum Value Modifier penalty in 2018 from 4% to 2%.

Click here to read AADA comments on the proposed rule.  The final 2018 Fee Schedule rule is expected to be released in November. 


AADA sends regulatory relief recs to Medicare Red Tape Relief Project

August 25, 2017 

The American Academy of Dermatology Association (AADA) today sent a letter to the U.S. House Ways and Means Committee offering recommendations for the Committee’s Medicare Red Tape Relief Project ― an initiative that seeks to mitigate burdensome Medicare regulations. Among several recommendations, the AADA suggested the streamlining of drug prior-authorization requirements.


AADA comments on 2018 QPP proposed rule

August 16, 2017

The Academy has submitted comments to the Centers for Medicare and Medicaid Services on the 2018 Quality Payment Program proposed ruleRead the letter.


CMS releases proposed 2018 Medicare Fee Schedule

July 13, 2017

The Centers for Medicare and Medicaid Services (CMS) today released the proposed 2018 Medicare Fee Schedule. Read the AADA breaking news alert with more information. AADA staff continues to analyze the rule, will be publishing other analyses, and plans to submit comments to CMS by September 11, 2017.


AADA supports House-passed medical liability reform legislation

June 28, 2017

With medical liability relief being among its health system reform principles, the AADA supported the Protecting Access to Care Act (H.R. 1215) to provide reforms to current medical liability laws and reduce health costs associated with defensive medicine. The legislation passed the House of Representatives on June 28. A letter offering the Academy's support for the legislation had been sent to Speaker Paul Ryan (R-WI), and a similar letter of support was sent by the Health Coalition on Liability and Access.


AADA opposes tanning tax repeal in BCRA

June 26, 2017

With the U.S. Senate expected to vote this week on the Better Care Reconciliation Act (BCRA), its version of legislation to repeal provisions of the Affordable Care Act, the AADA sent a letter to Senate leaders urging them to maintain the tax on indoor tanning services. The Joint Committee on Taxation estimates that repealing the tax would "...reduce revenues by approximately $622 million over the next 10 years, thereby ending a funding source that could be used to address other pressing public health challenges and priorities."  Click here to read the letter.


2018 Quality Payment Program (QPP) proposed rule just released

June 20, 2017 

Late this afternoon, the Centers for Medicare and Medicaid Services’ (CMS) released its anticipated proposed rule outlining policies for the 2018 Quality Payment Program (QPP). The American Academy of Dermatology Association is pleased that CMS has listened to physician groups such as ours and incorporated several important changes to the program. Read more.


AADA supports bill to ensure access to compounded drugs

June 16, 2017

Congressman Morgan Griffith (R-VA) and Congressman Henry Cuellar (D-TX) have introduced legislation to address the unintended consequences of the Food and Drug Administration's (FDA) interpretation of the Drug Quality and Security Act and facilitate physician access to compounded drugs for administration in a clinical setting. The AADA has sent a letter of support for the legislation, titled the Preserving Patient Access to Compounded Medications Act (H.R. 2871).


U.S. Senate passes 'Melanoma Awareness Month' resolution

May 25, 2017

The U.S. Senate has unanimously passed a resolution supported by the AADA designating May 2017 as "Melanoma Awareness Month."  This resolution - co-authored by U.S. Senators Jack Reed (D-RI), Johnny Isakson (R-GA), and Dick Durbin (D-IL) - also encourages the use of sunscreen and protective clothing, supports initiatives to help spread greater awareness of the importance of regular skin checks and the proper application of sunscreen, and supports research for prevention, detection, treatment and a cure for melanoma.  Read the AADA's letter supporting this resolution.

A similar resolution, also supported by the AADA, has been introduced in the U.S. House of Representatives.  Click here for more.


Lawmakers push FDA to rescind guidance on compounding

May 24, 2017

Congressmen Buddy Carter (R-GA) and Chris Stewart (R-UT) spearheaded a letter to Food and Drug Administration Commissioner Scott Gottlieb urging the agency to rescind Guidance for Industry issued in December 2016 that restricts physician and patient access to compounded drugs for office-use. This letter, which was signed by 65 members of the House of Representatives, was supported by the AADA and the Drug Quality and Security Act (DQSA) Coalition.


Regulatory relief for physicians recommended by lawmakers to HHS Secretary Price

May 24, 2017 

With the support of the AADA and other organizations that are members of the Physicians' Regulatory Relief Coalition, a bipartisan group of U.S. Representatives sent a letter to Health and Human Services (HHS) Secretary Tom Price, MD, expressing their support for regulatory relief for physicians.  This letter was sent before the release of the Medicare physician fee schedule, which is set to take place this summer. 

In their letter the lawmakers recommend that HHS consider: reducing the potential penalties provided for under the Value-Based Payment Modifier, adopting broader Electronic Heath Record (EHR) “Meaningful Use” (MU) Hardship Exemptions, and easing the burdens of the Physician Quality Reporting System (PQRS).  Click here to read the letter.


AADA sends advocacy positions and priorities to Senate Finance Chairman

May 23, 2017

In response to a request from Senator Orrin Hatch (R-UT), Chair of the Senate Finance Committee, for comments on the American Health Care Act (AHCA) and the Affordable Care Act (ACA), the AADA has sent a letter highlighting the Academy's advocacy positions and priorities.  This letter also includes a copy of the AADA's Health System Reform Principles.  Click here to read the letter.


AADA leads multi-organization letter to Senate opposing tanning tax repeal

May 11, 2017

The AADA has led a multi-organization letter to Senate Majority Leader Mitch McConnell (R-KY) and Senate Minority Leader Charles Schumer (D-NY) opposing the repeal of the indoor tanning tax in the American Health Care Act (AHCA), the proposed replacement for the Affordable Care Act.  The AHCA passed the House of Representatives on May 4, 2017. Click here for the letter and the list of signers
 


AADA supports Congressional resolution urging childhood skin protection

May 3, 2017

On behalf of the Congressional Skin Cancer Caucus, U.S. Representative Charlie Dent (D-Pa.) ― along with Reps. David Joyce (R-Ohio), Carolyn Maloney (D-N.Y.), Rosa DeLauro (D-Conn.), Jim Cooper (D-Tenn.), and Evan Jenkins (R-W. Va.) ― has again introduced a resolution (H. Res. 282) encouraging state, local, and community efforts to grant access to sunscreens in schools and expand access to sun safety in camps and other child care centers. The resolution also supports initiatives that encourage health care providers to educate parents and children about sun-safe behaviors. A similar resolution was introduced in the last Congress.

Academy President Henry W. Lim, MD, FAAD, has submitted a letter of support for H. Res. 282. Click here to read the letter.


AADA joins letter opposing cuts to medical research & cancer prevention efforts

March 23, 2017 

The AADA and other members of the One Voice Against Cancer (OVAC) coalition have sent a letter to Congressional leaders opposing potential cuts to the National Institutes of Health (NIH) and ultimately the National Cancer Institute (NCI) included in President Trump's budget proposal for Fiscal Year 2018.  Funding medical research is among the Academy's 2017 advocacy priorities.  Read the OVAC coalition letter, and learn more about the Academy's advocacy priorities for the coming year.


AADA leads multi-organization letter opposing tanning tax repeal

March 22, 2017

The AADA has led a multi-organization letter to Speaker of the House Paul Ryan (R-WI) and House Minority Leader Nancy Pelosi (D-CA) opposing the repeal of the indoor tanning tax in the American Health Care Act (AHCA), the proposed replacement for the Affordable Care Act.  Click here for the letter and the list of signers.


AADA supports IPAB repeal

March 17, 2017

The AADA has joined a number of medical organizations in sending letters of support to the lead sponsors of legislation to repeal the Independent Payment Advisory Board (IPAB). The letters were sent to Senator John Cornyn (R-TX), Senator Ron Wyden (D-OR), Representative Phil Roe, MD (R-TN) and Representative Raul Ruiz, MD (D-CA).

The IPAB, which is part of the Affordable Care Act, could potentially impose indiscriminate new payment cuts on physicians. Repeal of the IPAB is among the Academy's 2017 advocacy priorities. Read more about IPAB in the March issue of Dermatology World.


AADA opposes indoor tanning tax repeal

March 8, 2017 

The AADA has sent a letter to congressional leaders opposing the repeal of the indoor tanning tax. Among several provisions, the proposed replacement for the Affordable Care Act ― the American Health Care Act (AHCA) ― would repeal the indoor tanning tax.

In the letter, AADA President Henry Lim, MD, states, “With an epidemic of skin cancer which has grown to more than 4 million in number annually, dermatologists have made it a priority to advance public policies that promote prevention and education about skin cancer and the dangers of indoor tanning. By helping to raise awareness of the dangers of indoor tanning, the tax also can serve as a deterrent to help mitigate the risks associated with indoor tanning which are often not shared with customers of indoor tanning facilities.” According the Congressional Budget Office, repealing the indoor tanning tax will add $800 million to the federal deficit.


NIAMS Update for the Academy

March 2, 2017

The National Institute of Arthritis and Musculoskeletal and Skin Diseases, which is one of the institutes and centers comprising the National Institutes of Health, has provided the Academy with an annual update on its research activities and plans.  Read more.


Senate Committee approves Dr. Price

February 1, 2017
The Senate Finance Committee has approved the nomination of Tom Price, MD, to serve as secretary of HHS. Dr. Price's nomination will now go to the full Senate for a vote.

A vote on Dr. Price's approval was delayed yesterday in the Senate Finance Committee after committee Democrats boycotted the vote. The Committee rules require that at least one Democratic member must be present for the Committee to proceed. However, today Committee Republicans agreed by unanimous consent to temporarily change the committee’s rules, thereby allowing the committee to vote in favor of approving Dr. Price.


Senate committee to vote on Dr. Tom Price for HHS Secretary

January 30, 2017
The Senate Finance Committee this week is expected to approve Tom Price, MD, to serve as secretary of the Department of Health and Human Services (HHS) under the Trump Administration. Read more.


2017 Medicare Physician Fee Schedule released

November 2, 2016
CMS released the 2017 Medicare Physician Fee Schedule Final Rule Nov. 2, 2016. While providing overall a 0% increase in dermatology payments, the fee schedule also contains important developments for dermatology, such as a modified reporting burden on global periods. Learn more about the final fee schedule.


CMS announces new MACRA physician payment rule

October 14, 2016
The new MACRA rule takes effect Jan. 1, 2017, with “ramp up” time for physicians who wish to participate; participating physicians could see as much as + 4% bonus payment in 2019. Read more.


Congress introduces resolution urging childhood skin protection

September 13, 2016
The Academy submitted a letter of support for H. Res. 854, a resolution supporting state, local, and community initiatives to encourage parents, teachers, camp counselors, and child-care professionals to take measures to prevent sunburns in the minors and to support efforts to curb the incidences of skin cancer beginning with childhood skin protection. Read the letter.


CMS announces new flexibility on MACRA, final rule to be released this fall

September 8, 2016
CMS announced the agency's plans to allow providers to “pick their pace” for participating in the Merit-Based Incentive Payment System (MIPS) that was created under the Medicare Access and Chip Reauthorization Act (MACRA). The proposal outlines several options for physicians to report in the first year of the program while avoiding penalties. Read more.


AAD comments on 2017 Fee Schedule

August 30, 2016
The Academy submitted comments to CMS on the proposed 2017 Medicare Fee Schedule. Read the letter.


AADA voices dermatology’s concerns to CMS and congressional leaders about the proposed MACRA rule

July 27, 2016
The AADA is leading an aggressive effort to share our perspective and secure changes in the final rule that will enable dermatologists to succeed as Medicare moves from a pay-for-volume to a pay-for-value system. Read more.


AADA opposes VA proposal

July 26, 2016
The American Academy of Dermatology Association submitted a letter opposing the Department of Veterans Affairs’ proposal to allow full practice authority for all VA advanced practice nurse practitioners (APRNs) because it contradicts the physician-led, team-based care model and unnecessarily preempts state collaborative agreement requirements. Read the letter.


Academy submits input to FDA on compounding

July 19, 2016
The Academy submitted input to the Food and Drug Administration (FDA) in response to its draft guidance on:


CMS releases proposed rule that would maintain 90-day reporting period for Meaningful Use

July 7, 2016
CMS released a proposed rule that would maintain a 90-day reporting period for the EHR Meaningful Use program in 2016. The “Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Organ Procurement Organization Reporting and Communication; Transplant Outcome Measures and Documentation,” was published just hours before the Proposed Rule for the Medicare Physician Fee Schedule was also released. 

Maintaining a 90-Day Reporting Period for the Meaningful Use (MU) Program in 2016 has been a top priority for the Academy. As part of an informal coalition, the Academy has been engaged with CMS and Congress since the start of the year to move from the full year of reporting requirement to a 90-day reporting period for MU in 2016.

In March, the Academy joined the attached letter to CMS requesting a 90-day reporting period for 2016. Due to coalition efforts, in April, Members of Congress introduced the bipartisan and bicameral (House and Senate) “Flexibility in Electronic Health Record Reporting Act” (S.2822/H.R.5001), which would allow physicians to demonstrate meaningful use of electronic health records in 2016.

The Academy supported the legislation upon introduction and sent the attached letters to all original sponsors and co-sponsors. Academy grassroots was activated on the legislation with an all member alert sent on April 28. The legislation’s introduction as well as the grassroots action was featured in DermWorld Weekly on April 27. The grassroots activity resulted in 1,482 letters sent to 297 Members of Congress by 418 dermatologists.


Dermatology to see 1 percent payment increase from Medicare in 2017 under proposed rule

July 7, 2016
The Centers for Medicare and Medicaid Services (CMS) released the proposed 2017 Medicare Physician Fee Schedule. While the overall impact of the proposed rule is a 1 percent increase in payments for dermatology, the American Academy of Dermatology Association is assessing the impact of several elements of the rule, including two related to global periods. Read more.

For a detailed summary of the rule, go to www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-07-07-2.html.

In a separate proposed rule, CMS indicated that it will reduce the reporting period for meaningful use of electronic health records in 2016 from a full year to 90 days. The AADA advocated strongly for this change.


Academy calls for MACRA delay, expansion of exception criteria

June 28, 2016
The comment period requesting feedback on CMS’s Medicare Access and CHIP Reauthorization (MACRA) proposed rule has come to a close. CMS received a deluge of comments from the medical community, including the AADA. In its comment letter, the AADA is requesting that CMS delay implementation of the MACRA rule from Jan. 1, 2017, to Jan. 1, 2018. The proposed rule outlines sweeping changes to Medicare payments and quality reporting — instituting two Medicare participation tracks: the Merit-Based Incentive Payment System (MIPS) and the Advanced Alternative Payment Model program. The proposed rule stems from provisions required in the MACRA law that repealed and replaced the sustainable growth rate formula in 2015. The final rule is expected to be released in November 2016.

Specifically, the Academy requested that CMS modify the low-volume threshold — that would exempt physicians from participating in MACRA — to those whose Medicare billing charges are $75,000 or less and provide care for 750 or fewer Part B-enrolled Medicare beneficiaries, as opposed to $10,000 or 100 patients per physician. Additionally, the AADA asked CMS to shorten the reporting period from one year to three months and reduce the reporting requirement from 80 percent of MIPS eligible clinicians’ patients to 50 percent. Read more from the AADA’s comment letter. Find out more about how the proposed rule will affect your practice in the May 4 issue of Dermatology World Weekly.


Projected Medicare expenditures for 2017 will not trigger IPAB action

June 28, 2016
According to a report released by Medicare’s trustees, Medicare’s trust fund will remain solvent until 2028. The report also noted that based on the projected spending levels for Medicare in 2016, the five-year average growth in spending will not exceed the level that would trigger the need for the Independent Payment Advisory Board (IPAB) to make recommendations on reducing Medicare expenditures. The IPAB, created under the Affordable Care Act (ACA), is tasked with containing Medicare costs if they exceed certain levels. No members have been appointed and spending has not yet exceeded the target at which recommendations would be required.

The IPAB is not the only piece of the ACA that has affected patients and physicians. The development of the health insurance marketplace has increased the number of insured patients — but the newly insured often have high-deductible plans. Read more about getting paid in the age of high deductibles in Dermatology World.


FDA releases final guidance on compounding using bulk drug substances

June 9 , 2016
The FDA released its final guidance titled “Interim Policy on Compounding Using Bulk Drug Substances Under Section 503A of the Federal Food, Drug, and Cosmetic Act.” The AADA asked the FDA to finalize its proposal to not take enforcement action against bulk substances, such as canatharidin, that FDA had approved for inclusion on the bulk substance list but additions had not been finalized through notice-and-comment rulemaking in the Federal Register. Read the AADA's comment letter.

In the final guidance, the FDA stated that it understood that the administrative process could be causing “unnecessary and inappropriate disruptions in patient care” and finalized its non-enforcement policy where the bulk drug substance nomination included adequate information for FDA evaluation and the substance does not appear to present significant safety risks. 


AADA testifies on in-office compounding

June 3, 2016
On Friday, June 3, Dr. Bruce Brod, chair of the Congressional Policy Committee, presented testimony at the FDA on compounding. Read Dr. Brod's testimony.


AADA fights to preserve in-office ancillary services exception

May 9, 2016
The AADA and members of the specialty community are strongly opposing the Promoting Integrity in Medicare Act. The bill calls for repeal of the in-office ancillary services exception (IOASE). If enacted, the legislation would severely limit patient access to life-saving pathology services provided within coordinated care models. While the AADA does not expect any movement on the bill during this year’s Congressional session, it will continue to monitor discussions and fight to preserve dermatopathology services for patients Read the comment letter.