Advocacy news briefing

advocacy news banner1

2019 Fee Schedule: More on global payments, E/M, modifier 25, and telemedicine

Nov. 14, 2018

What are CMS’s plans for global codes? Evaluation and management payments and reporting requirements? What’s happening with modifier 25? Telemedicine reimbursement? Find out in Dermatology World Weekly.


​Fee Schedule: How will your practice fare in 2019?

Nov. 7, 2018

The 2019 final Medicare physician fee schedule is out, and while dermatology as a specialty will see about a 1% increase in payments overall, how will your individual practice be affected? Check out the Academy’s listing of payment changes to the top dermatologic codes and find out how reimbursement for your mix of services will change.


Modifier 25 payment reduction canceled in 2019 Medicare final fee schedule

Nov. 1, 2018

Dermatology will see an estimated increase in overall payments of 1% next year based on the American Academy of Dermatology Association’s analysis of the 2019 Medicare physician fee schedule published Nov. 1. Exact impact on specific practices will depend on physicians' individual patient mix.

Thanks to advocacy by the AADA and its members, CMS has backed away from a concerning proposal to make aggressive changes to payment associated with modifier 25 and delayed a proposal to collapse E/M codes.

Read more headlines from the 2019 final Medicare physician fee schedule.


AADA, coalition call on Congress to ask CMS to withdraw QCDR proposal

Oct. 25, 2018

The AADA, as part of the Physician Clinical Registry Coalition, issued letters to key congressional committee leaders expressing concerns about CMS’s recent proposal to require Qualified Clinical Data Registry (QCDR) measure owners to enter into licensing agreements with CMS. The proposal would permit the agency to allow any other approved QCDR to submit data on the licensed measure for purposes of Merit-based Incentive Payment System (MIPS) reporting, beginning with the 2021 MIPS payment year.

The coalition argues that the proposal “would take away QCDRs’ ability to ensure that only qualified third parties can use their measures and that their measures are used appropriately.” Additionally, the group argued that the proposal would remove QCDRs’ ability to license measures and as a result “would prevent medical society QCDR owners, who have made considerable investments of time, effort, and resources in developing their measures, from offsetting the cost of measure development.”

The coalition also argued that the agency’s policy reversal "will have an adverse effect on QCDR measure development and may impact QCDR participation by medical specialty societies and other organizations with clinical experience in measure development, which would directly conflict with the intent and goals of MACRA. Without the leadership and contribution of medical societies, the QCDR measures available to eligible clinicians may be poorly refined and inaccurately capture quality performance."


Pennsylvania governor signs sunscreen access bill

Oct. 25, 2018

Pennsylvania Gov. Tom Wolf has signed legislation into law that allows students to bring sunscreen to school without a physician’s note. The bill, HB 1228, also provides for use of sun-protective clothing and hats.

The Pennsylvania Academy of Dermatology and Dermatologic Surgery (PAD) and the American Academy of Dermatology Association (AADA) advocated in support of this legislation. PAD received an AADA State Advocacy Grant in 2018 to advocate on the issue.


Drug shortages affecting your patients? Tell the FDA.

Oct. 24, 2018

The American Academy of Dermatology Association (AADA) is conducting a survey of Academy members about the effects of drug shortages on dermatology patients. The AADA plans to share the results with the FDA and other policymakers on the federal and state legislative levels. Take the survey here.

The AADA has been engaging with stakeholders — including manufacturers, suppliers, the FDA, and Congress — to facilitate access for patient care. Bruce Brod, MD, deputy chair of the Academy’s Council on Government Affairs and Health Policy, recently participated in an FDA listening session with other medical specialties on the clinical and economic impacts of drug shortages. The listening session comes on the heels of the creation of the FDA’s new Drug Shortages Task Force that plans to address the causes of drug shortages and develop long-term solutions.


Members of Congress call on HHS to address barriers to data sharing

Oct. 12, 2018

Several members of Congress have joined a sign-on letter calling on HHS Sec. Alex Azar to address barriers to data sharing between qualified clinical data registries (QCDR) and electronic health record (EHR) systems. The letter raised concerns about EHR vendors’ practices that are blocking the transfer of data between EHRs and QCDRs. The letter also notes that QCDRs can facilitate reporting under the Merit-Based Incentive Payment System (MIPS), by saving time and reducing the paperwork burden on physicians. Improving data sharing between EHRs and QCDRs was one of the AADA’s legislative “asks” at its 2018 Legislative Conference.

Click here to read the letter.


Issue breakdown: Compounding standard would disrupt care

Dermatologists welcomed news last month that the FDA may not enforce burdensome requirements of physicians engaging in common compounding practices such as buffering lidocaine in their offices. However, this might simply tip the issue to the states as new compounding standards are expected from The United States Pharmacopeial Convention (USP) that would suggest similarly burdensome requirements on physician offices.

What is USP and why does it matter?
USP is an independent non-profit group that develops health care quality standards. While they are not a regulatory agency and don’t have any enforcement authority, their standards are often adopted by those who do, including federal and state policymakers and accreditation bodies like the FDA, CMS, the CDC, the Joint Commission, and state pharmacy boards.

Updates to chapter 797 of USP’s compounding standards, which outline requirements for compounding sterile drugs in physician offices, have been or could be adopted at the state level across the country.

If you live in a state where the pharmacy board has or is considering adopting chapter 797 for physician offices, this proposal is particularly important.

What does 797 mean for dermatology?
The revised standards as currently proposed outline a number of requirements that would create burdens in dermatology offices engaged in common patient care activities. The new standards suggest requirements for compounding personnel, training, facilities, environmental monitoring, and storage and testing of finished preparations. These proposals would impact everyday activities like how you buffer lidocaine (with or without epinephrine) without sodium bicarbonate, dilute triamcinolone acetonide, and reconstitute botulinum toxins. For example, one proposal would require the administration of buffered lidocaine within one hour of preparation.

What is the AADA doing?
Although the USP is not a government group, they do work for transparency in their process. As such, they seek input from outside experts during the development of new standards and updates and obtain public comment from stakeholders before final publication

The American Academy of Dermatology Association’s Compounding Workgroup analyzed the draft revisions and will be providing detailed comment on its impact on care, particularly the need for access to compounded sterile preparations in dermatology.

What can I do?
While the AADA’s official response is critical, impacted dermatologists need to weigh in as well. The first version of these standards received 8,000 public comments, sending USP back to the drawing board. Hearing from you will ensure that the final standard reflects the best practice for dermatology patients.

Send your comment to USP with the AADA’s easy-to-use tool. Comments are due by Nov. 30.


Congress passes legislation creating streamlined prior authorization process for drugs

Oct. 4, 2018

Congress has passed legislation that would require CMS to create a standardized electronic process for Medicare prior authorizations for medically necessary drugs in Medicare Advantage and Medicare Part D participating plans. A standardized electronic form would help shorten the turnaround time for decisions, encourage plans to allow for electronic prior authorization (ePA), and require detailed explanations and clinical rationale for denials and adverse determinations.

The American Academy of Dermatology Association (AADA) lobbied in support of this provision and it was one of the legislative “asks” at the 2018 AADA Legislative Conference. This language was included as part of the Substance Use–Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (HR 6). The legislation has been sent to President Trump to be signed into law.


Budget bill victories for dermatology include skin cancer prevention and melanoma research funding

Oct. 1, 2018

The CDC will have $3 million to spend on skin cancer prevention programs in 2019, up from $2.15 million in 2018. The American Academy of Dermatology Association (AADA) advocated for this increase in funding. The funding was included in legislation to keep the government funded beyond Election Day.

The bill also included increases for the NIH — including the National Cancer Institute and National Institute for Arthritis and Musculoskeletal and Skin Diseases. The legislation funded these agencies for all of fiscal year 2019. The AADA advocated for the increases.

Specifically, NIAMS will see an $18 million increase in funding in 2019; its $605 million allocation is less than the $620 million the AADA sought but significantly more than the $545 million included in President Trump’s budget proposal. Similarly, the NCI will receive $6.15 billion in funding, rising from $5.9 billion in 2018 and $5.6 billion in the president’s 2019 proposal. The NIH as a whole received a $2 billion funding increase from 2018 to 2019.

Finally, the Department of Defense portion of the legislation includes $10 million in funding for melanoma research. The AADA signed on to a letter from the National Council for Skin Cancer Prevention seeking this funding. As a result, rather than competing for funding with other types of cancer, melanoma has its own line item, along with breast, ovarian, and prostate cancers.


House and Senate pass legislation prohibiting gag clauses

Oct. 1, 2018

The House and Senate have passed legislation that would prohibit pharmacy benefits managers (PBMs) and private payers from including gag clauses in contracts with pharmacists that forbid them from telling patients a drug may be cheaper out-of-pocket rather than going through their insurance. The Know the Lowest Price Act applies to drug plans under Medicare Part D and Medicare Advantage and the Patient Right to Know Drug Prices Act applies to group health plans and individual market exchange plans. The legislation has been sent to President Trump to be signed into law. The AADA lobbied in support of this legislation.


AADA, coalition urge congressional leaders to ask CMS to reconsider MA step therapy policy

Sept. 14, 2018

The AADA joined more than 240 patient and provider groups in signing on to a letter — organized by the Part B Access for Seniors and Physicians Coalition — that asks House and Senate leadership to call on CMS to reconsider their proposal that would allow Medicare Advantage to implement step therapy to manage Part B drugs. Read more from the coaltion.


AADA supports Ensuring Lasting Smiles Act

Sept. 11, 2018

The AADA, along with several other medical societies, has sent letters to members of the House and Senate in support of bipartisan legislation that would ensure coverage for children born with congenital anomalies or birth defects. HR 6689 and S 3369, the Ensuring Lasting Smiles Act, will address the issue of insurance denials for procedures that functionally repair or restore any body part that is medically necessary to achieve normal body functioning or appearance.


AADA supports Resident Education Deferred Interest Act

July 31, 2018

The AADA has joined a number of organizations in supporting the Resident Education Deferred Interest (REDI) Act (H.R. 5734), which was introduced by Congressman Brian Babin, DDS (R-TX). The REDI Act would halt the accrual of interest on loans that qualify for forbearance or deferment while a physician or dentist is in an internship or residency.
 
Currently, all graduate loans are unsubsidized; therefore, interest continues to accrue on the loans even if a physician or dentist qualifies for forbearance or deferment during residency because they cannot afford to make monthly payments. The accrual of the interest can add tens of thousands of dollars to their overall loan depending the balance, interest rate, and length of residency.  The legislation is designed to provide some relief to young physicians as they face significant student loan debt post-training.

Click here to read the letter in support of the REDI Act.


AADA statement on MACRA and MIPS for E&C Health Subcommittee

July 26, 2018

In a statement for the U.S. House of Representatives' Energy & Commerce Health Subcommittee oversight hearing entitled “MACRA & MIPS: An Update on the Merit-Based Incentive Payment System,” the AADA shared its concerns regarding cost performance, detailed needed changes to the Qualified Clinical Data Registry (QCDR) measures approval process, discussed ongoing difficulties with electronic health record (EHR) vendors and data blocking, and highlighted additional ways to reduce physician burden.

Click here to read the letter.


AADA continues engaging FDA, industry on sunscreen ingredients

July 23, 2018

The AADA has submitted a comment letter to the Food and Drug Administration (FDA) in response to its draft guidance on Maximal Usage Trials for Topical Active Ingredients Being Considered for Inclusion in an Over the Counter Monograph: Study Elements and Considerations. In its letter, the AADA emphasizes implications that recent proposals to ban the sale and distribution of sunscreens containing oxybenzone and octinoxate can have on the American public, as access to a broad range of sunscreen ingredients may become further limited. Additionally, the AADA again expresses the desire to facilitate discussion between the FDA and industry with the desired goal of new safe (and effective) sunscreen active ingredients becoming available in the United States.

Read the letter.


AADA comments on Administration’s plan to lower drug prices

July 12, 2018

The AADA today submitted its comments on the Trump Administration's Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. Patient access to affordable treatments and transparency in drug pricing are top priorities for the Academy.

In its comment letter, the AADA details the increasing complex drug pricing process for both generic and specialty medications. Among its comments, the AADA advocates for transparency in how Pharmacy Benefit Managers (PBMs) operate in setting drug prices and lifting the "gag clause" by health insurance providers and PBMs that restricts pharmacists from informing patients that a certain drug is cheaper if paid out-of-pocket rather than through insurance. The AADA also supports changes to streamline and reduce delays for prior authorizations in Medicare and encourages further action by the Food and Drug Administration to address ongoing drug shortages.

Click here to read AADA comments on the Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs.


Proposed CMS rule overhauls E/M visit codes, reduces modifier 25 payment

June 12, 2018

The Centers for Medicare and Medicaid Services (CMS) today released its proposed 2019 Medicare Physician Fee Schedule rule, which also includes changes to its proposed policies for the 2019 Quality Payment Program (QPP) established under the Medicare Access and CHIP Reauthorization Act (MACRA). In addition to proposing an overhaul of evaluation and management (E/M) visits, the AADA is very concerned that CMS also is proposing a payment reduction for E/M visits billed with a procedure.

AADA staff continues analyzing the proposed rule and plans to submit comments to CMS by Sept. 10, 2018. This Academy webpage includes the AADA's initial topline analysis of the proposed rule, and will be updated with additional details following further review. Information will also be made available in Dermatology World Weekly.


CMS denies Massachussetts' request to limit Medicaid drug coverage

June 27, 2018

The Centers for Medicare and Medicaid Services (CMS) today denied Massachusetts’ request to choose which drugs it would cover in its Medicaid program. Massachusetts would have been the first state with this policy. 

The AADA joined a number of state dermatological societies in opposing this request, arguing that "A formulary that includes only one drug per class is an ineffective, draconian approach to reducing health care costs by creating a one-size-fits-all solution." Members of the Massachusetts delegation in the U.S. House of Representatives also expressed concerns about the request in a letter to the state's governor.


AADA opposes bill to repeal tan tax

June 15, 2018

The AADA opposed the Tanning Tax Repeal Act of 2018 (S. 2600) in a letter to U.S. Senators Rand Paul (R-KY) and Heidi Heitkamp (D-ND). The letter emphasizes that evidence from multiples studies shows that exposure to ultraviolet radiation from indoor tanning devices is associated with an increased risk of skin cancer. Read the letter.


AADA, coalition oppose federal bill to expand audiologists’ scope of practice

May 18, 2018

The AADA joined other physician organizations in strongly opposing legislation introduced in the U.S. Senate (S. 2575) to include audiologists in the definition of “physician,” which would allow them unlimited direct access to Medicare beneficiaries without a physician referral. The letter cites patient safety concerns, confusion regarding the qualifications and training of various health care providers, and concerns about broadening the term "physician" to include non-physician health care providers. Click here to read the letter opposing the legislation.


AADA comments on network directory accuracy, rebates, and prior authorization

May 8, 2018

In a statement for the U.S. House Ways and Means Committee's Subcommittee on Health, the AADA expressed concerns regarding network directory accuracy, the rising use of rebates, and significant burdens when meeting Medicare Part C and D plans' prior authorization requirements for medically necessary drugs. The statement was for a hearing entitled the Current Status of and Quality in the Medicare Advantage Program. Read the AADA's statement for the record.


AADA, HDS send letter to HI gov. on sunscreen ingredient restriction

May 7, 2018

Along with the Hawaii Dermatological Society, the AADA sent a letter to Hawaii's governor, David Y. Ige, expressing concerns about state legislation to prohibit the sale and distribution in Hawaii of ultraviolet sun protection factor sunscreen personal care products containing oxybenzone and octinxate without a prescription. The letter encouraged Gov. Ige to strongly consider the broad implications of banning oxybenzone sunscreens, and the dangers of sun exposure that Hawaii residents and visitors would face if this legislation is signed into law. It also encourages Gov. Ige to be involved in discussions with the Food and Drug Administration, industry, and the AADA on adding new safe and effective sunscreen ingredients, especially to ensure broad spectrum protection. Read the letter. A similar letter had also been sent to Hawaii's House and Senate.

Check out our Media Relations Toolkit for more information.


AADA highlights telehealth's role in ensuring access to board-certified dermatologists

April 26, 2018

The AADA highlighted its work with AccessDerm and Project Echo in a statement for the record for a congressional hearing entitled “Innovation in Health Care." The hearing, which was held by the House Ways and Means Committee's Subcommittee on Health, focused primarily on telehealth.

In its statement, the AADA reiterated the Academy's mission to improve the quality of dermatologic care available to underserved populations in the United States by facilitating access to board-certified dermatologists. Read the statement.


AMA, AADA call for reduced 2018 MIPS quality reporting period

April 20, 2018

The American Medical Association recently led letter calling on the Centers for Medicare and Medicaid Services (CMS) to reduce the 2018 Merit-based Incentive Payment System (MIPS) quality measure reporting performance period due to CMS delays as well as administrative burdens associated with reporting. The AADA joined nearly 50 medical associations in signing onto the letter. Read the letter here.

The letter asks that the 2018 MIPS reporting period be reduced from a full calendar year to a minimum of 90 consecutive days as the result of a lack of timely, direct notification regarding whether a physician is MIPS-eligible. Furthermore, the Quality Payment Program (QPP) website will not be updated with 2018 information until the summer of 2018, at the earliest. This will make it difficult for physicians to meet the full-year quality data reporting requirements for 2018. The letter also calls for a reduced reporting period for future MIPS program years to reduce administrative burdens.


AADA supports prohibiting "gag clauses" keeping pharmacists from revealing lower-cost drug options

April 3, 2018

The AADA has sent letters supporting two bipartisan bills in the Senate aimed at lifting the "gag clause" that restricts pharmacists from informing patients that a drug is cheaper if they purchase it out-of-pocket instead of through their insurance. For example, a recent study published in JAMA identifies prednisone, to treat severe psoriasis, as among the top 20 drugs for which patients paid more going through their insurance than if they were to have paid out-of-pocket. This gag clause is frequently included in contracts between pharmacies, insurers, and pharmacy benefit managers (PBMs).

The Know the Lowest Price Act of 2018 (S. 2553), introduced by Senators Debbie Stabenow (D-MI) and Susan Collins (R-ME), would prohibit gag clause restriction for drugs covered under Medicare Part D and Medicare Advantage plans. The Patient Right to Know Drug Prices Act (S. 2554), introduced by Senators Susan Collins (R-ME) and Sen. Claire McCaskill (D-MO), would prohibit this restriction for drugs covered under the individual market exchanges as well as group plans covered by ERISA. Both bills also prohibit the pharmacy from being penalized for providing this information to the patient.

Read the AADA's letters of support for the Know the Lowest Price Act and the Patient Right to Know Drug Prices Act.


AADA pushes for more advanced sunscreen ingredients to market

March 23, 2018

In a letter regarding the Over-the-Counter (OTC) Drug Safety, Innovation and Reform Act (S. 2315), the AADA wrote in support of the introduction of new sunscreen ingredients that are safe and effective, and also for maintaining access to current sunscreen ingredients. While the letter encourages efforts to get more advanced sunscreen ingredients to market, the AADA is neutral on the remainder of the legislation. Read more.


AADA submits statement on MACRA implementation

March 21, 2018

The House Ways and Means Committee's Subcommittee on Health held an oversight hearing today entitled "Implementation of MACRA's Physician Payment Policies." The AADA submitted a statement for the committee hearing record, which highlighted ongoing concerns with 1) attribution of costs under the cost performance category of the Merit-Based Incentive Payment System (MIPS); 2) concerns regarding the measures approval process for Qualified Clinical Data Registries (QCDRs) like DataDerm; and 3) the blocking of electronic health record data from being accessed by QCDRs. Read the statement.


AADA supports bill to streamline prior authorization approval in Medicare

February 27, 2018

The AADA has sent a letter of support for the Standardizing Electronic Prior Authorization for Safe Prescribing Act (HR 4841), legislation intended to streamline and reduce delays for prior authorization approval in Medicare. The legislation would require the Centers for Medicare and Medicaid Services (CMS) to provide for the development of an electronic prior authorization standard for Part D and Medicare Advantage plans. The bill does not mandate that physicians or plans use it, but is intended to be a stepping stone to streamlining the prior authorization process.

Learn more in the AADA's letter of support for the Standardizing Electronic Prior Authorization for Safe Prescribing Act. To access the Academy's prior authorization assistance tools, click here.


AADA, other specialties continue pressing FDA on drug shortages

February 23, 2018

The AADA was joined by other specialties in advocating that the Food and Drug Administration (FDA) build upon working relationships with manufacturers to address drug shortages that continue having adverse impacts on patients. In their letter to FDA Commissioner Scott Gottlieb, MD, the organizations specifically express concern regarding ongoing shortages of lidocaine with epinephrine, lidocaine, and other local anesthetics, and suggest ways the FDA could engage. Read the letter.

Learn more about the AADA’s advocacy on drug shortages.

 


Anthem RESCINDS proposed modifier 25 policy in win for AADA, AMA, patient care

February 23, 2018

Anthem, Inc. today announced it is rescinding its proposed policy to reduce reimbursement by 25% for E/M services billed with a modifier 25. Anthem’s initial proposal had been a 50% cut, which they reduced and delayed 3 months in response to AADA advocacy. Recent AADA advocacy included a letter to Anthem earlier this week encouraging the payer to retract its policy. 

Learn more in the President's Message from AAD/A President Suzanne Olbricht, MD.


AADA joins coalition letters supporting cancer research & prevention funding

February 21, 2018

The AADA joined fellow members of the One Voice Against Cancer Coalition (OVAC) in sending letters to relevant Senate and House committees in support of increased funding for medical research at the National Institutes of Health (NIH) to advance evidence-based cancer prevention and control programs. Increasing funding for medical research is one of the AADA’s advocacy priorities.


Academy members discuss improving access to care

February 17, 2017

For the third year, the Academy held a learning collaborative to provide a forum for members to share ideas for how to improve access to dermatologic care for patients and other physicians. At the Access to care Learning Collaborative, several speakers each presented a case in which their unique way of increasing access better served an individual patient.

Access to Care Learning Collaborative


Stopgap funding bill includes health care wins

February 9, 2018

The AADA is pleased with a bill passed by Congress today that, in addition to funding the government through March 23, repeals the Independent Payment Advisory Board (IPAB) and stops an effort to extend the misvalued codes policy, two top AADA legislative priorities.

These successes culminate efforts by hundreds of AADA members who lobbied their members of Congress at annual AADA Legislative Conferences, in response to grassroots calls to action, and in comment letters to Congressional leaders.

IPAB created the potential to impose indiscriminate new payment cuts on physicians, while the misvalued codes policy required CMS to cut the Medicare Fee Schedule by .5% by correcting “misvalued” codes or through across-the-board cuts.

Additionally the bill includes AADA-supported provisions that:

  • Relieve MACRA burdens through adjustments to MIPS, including eliminating mandates that EHR standards become more stringent each year.
  • Expand access to telehealth services within Medicare Advantage beginning in 2020.
  • Fund Community Health Centers for two years. 

While the Academy applauds the above positive actions, concerns remain about provisions that lower automatic updates to the 2019 Medicare Physician Fee Schedule from .5% to .25% and extend mandatory Medicare Sequestration cuts another year. The bill also reduces funding to the Prevention and Public Health Fund, which covers skin cancer prevention, among other priorities. The Academy will continue longstanding advocacy efforts supporting fair and reasonable Medicare payment and adequate funding for prevention and public health awareness.

On February 7, the AADA provided its comments regarding provisions in the legislation. Look for additional updates on how these changes will affect dermatologists in upcoming issues of Dermatology World Weekly and on AAD.org.​


AADA testified before Congress on compounding issues

January 30, 2017

Bruce A. Brod, MD, FAAD, Chair of the AADA's Congressional Policy Committee, today testified on office-use compounded medications and in-office preparations before the House Energy and Commerce Committee's Subcommittee on Health. Also among those testifying were Scott Gottlieb, MD, who serves as the commissioner of the Food and Drug Administration. Click here for more information on the hearing, to watch the hearing, and to read Dr. Brod's statement for the record.

 Dr. Brod at E&C on compounding issues Photo by the House Energy and Commerce Committee.


AADA congratulates HHS Secretary Azar, encourages reg. relief efforts

January 24, 2018

The AADA congratulated Alex Azar on his appointment as Secretary of Health and Human Services after his nomination was confirmed by the U.S. Senate in a vote of 55-43. In its letter of congratulations, the AADA expressed appreciation for ongoing efforts to advance regulatory relief initiatives that alleviate burdens on physicians. The AADA also encouraged further collaboration in lifting burdensome regulations such as drug prior authorization requirements and requirements threatening access to compounded medications. Click here to read the letter.


AMA announces prior authorization Consensus Statement

January 17, 2018

The American Medical Association (AMA) announced a Consensus Statement along with the American Hospital Association (AHA), America's Health Insurance Plans (AHIP), American Pharmacists Association (APhA), Blue Cross Blue Shield Association (BCBSA) and Medical Group Management Association (MGMA) which outlines a "shared commitment to industry-wide improvements to prior authorization processes and patient-centered care." The Consensus Statement indicates that the organizations will work to reduce the number of health care professionals subject to prior authorization requirements; regularly review the services medications requiring prior authorization, improve channels of communications, protect continuity of care for patients, and accelerate industry adoption of national electronic standards for prior authorization. The AADA has long advocated for efforts to lessen the burden of prior authorization.

 Visit the AMA's website for more information on the Consensus Statement.


AADA joins letter opposing modifier 25, other Anthem payment changes

January 16, 2018

The AADA joined medical specialty societies and patient advocacy groups in sending a letter to Anthem's chief clinical officer to express concerns about controversial changes to Anthem payment policies. The letter urges the insurer to rescind plans to 1) reduce physicians' reimbursement when they bill for E&M services billed with a modifier 25, 2) largely deny advanced imaging performed in the hospital outpatient setting, and 3) deny coverage for services provided to beneficiaries for retroactively determined "non-emergent" health care services in the Emergency Department. The letter states that "Anthem finalized these changes despite mounting evidence that the justification for the policies is flawed and would hinder patients' access to physician care."

Click here to read the letter.


AADA comments on 2018 Medicare physician fee schedule & Quality Payment Program/MACRA rules

December 29, 2017

The AADA submitted comments on the 2018 Medicare Physician Fee Schedule final rule as well as the final rule for the 2018 Quality Payment Program (QPP), established under the Medicare Access and CHIP Reauthorization Act (MACRA). Both rules were released by the Centers for Medicare and Medicaid Services in November.

Click here to read the AADA's comments on the 2018 Medicare Physician Free Schedule rule.

Click here to read comments on the 2018 Quality Payment Program/MACRA rule.


Anthem delays, alters proposed modifier 25 policy following AADA, AMA advocacy

December 22, 2017

Anthem, Inc. announced on Dec. 22, 2017 that, while it will still be reducing reimbursement for E&M services billed with a modifier 25, reimbursement will be reduced by 25 percent rather than by 50 percent, as was originally announced. Anthem also announced that the policy will go into effect March 1, 2018 in California, Colorado, Connecticut, Indiana, Kentucky, Maine, Missouri, New Hampshire, Nevada, New York, Ohio, and Wisconsin. For some states, this is a delay in implementation. Anthem also indicated that the policy will be effective in Georgia and Virginia upon network contract renewal. Click here to read the Academy's Breaking News Alert for more on the American Academy of Dermatology Association's efforts to fight Anthem's proposed policy change along with the American Medical Association (AMA), other medical specialties, and state dermatologic societies.

 


AADA opposes misvalued codes, urges action on sequester

December 20, 2017

The AADA sent a letter to leadership of the U.S. Senate and U.S. House of Representatives opposing Medicare cuts to physician payments through either an extension of the misvalued codes policy or through an additional sequester of Medicare funds. To read the letter, click here.


AADA letter to Senate Cancer Coalition supporting tanning tax

December 19, 2017

The AADA sent a letter to members of the Senate Cancer Coalition reiterating the Academy's continued support for the excise tax on indoor tanning services, and opposing its repeal through the Tanning Tax Repeal Act of 2017 (H.R. 1150) or other mechanisms including but not limited to efforts to extend expiring Medicare provisions, measures to address certain health-related tax measures, or in any appropriations-related legislation. Click here to read the letter.


AADA, coalition letter on preserving patient access to Part B treatments

December 6, 2017

Several medical societies including the American Academy of Dermatology Association sent a letter to Congressional leaders urging them to preserve patients' access to critical Part B drug treatments by preventing the Centers for Medicare and Medicaid Services (CMS) from applying Merit-based Incentive Payment System (MIPS) score adjustments to Medicare Part B payments. In its 2018 Quality Payment Program (QPP) final rule, CMS announced it will be imposing these payment adjustments to Part B drug payments in addition to physicians' services under the Medicare fee schedule.  The letter requests a technical correction to curtail this policy and preserve patient access to the services and treatments they need.  To read the letter, click here.


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.


AADA comments on USPSTF skin cancer counseling recommendation

November 6, 2017

The AADA has sent a letter to the U.S. Preventive Services Task Force (USPSTF) in response to its draft recommendation statement and draft evidence review on behavioral counseling to prevent skin cancer. In its draft recommendation, USPSTF found that clinicians should provide counseling to anyone with fair skin ages 6 months to 24 years. The draft recommendation also said there is "insufficient evidence to determine if the benefits outweigh the harms from counseling adults about skin self-examinations for the prevention of skin cancer." Click here to read the AADA's comment letter.


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.