February 28



Another win for dermatology: Anthem rescinds proposed modifier 25 policy


Anthem, Inc. has announced that 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 was reduced and delayed three months in response to AADA advocacy.
This win is the result the AADA’s leadership of a strategic multi-faceted advocacy campaign to overturn the policy. This effort included close collaboration with the American Medical Association (AMA), state medical and dermatology societies, and other medical specialty societies, as well as direct engagement with Anthem to encourage them to retract the policy. The AMA has been a vital partner in these successful efforts, but without increasing membership in the AMA, the Academy stands to lose 25% of its delegation in the AMA’s House of Delegates. Visit www.ama-assn.org/membership to join the AMA and help keep dermatology strong in medicine and in advocacy.”

Read more about the Academy’s attempts to rein in this policy, and other payer policies, in Dermatology World.

Related Links: 

AAD election

Exercise your right to vote at www.aad.org/aadelection by March 3.


FDA grants rituximab priority review for pemphigus vulgaris

The U.S. Food and Drug Administration (FDA) has accepted Genentech’s supplemental Biologics License Application for the use of rituximab (Rituxan) for the treatment of moderate-to-severe pemphigus vulgaris. The drug has already been granted Breakthrough Therapy Designation and Orphan Drug Designation for the treatment of pemphigus vulgaris. Rituximab was approved as a treatment of relapsed or refractory low-grade or follicular, CD20-positive, B-cell non-Hodgkin’s lymphoma in 1997 and has since been approved for a number of indications including rheumatoid arthritis, granulomatosis with polyangiitis, and microscopic polyangiitis. 

Read more about how chimeric antigen receptor T cells can potentially cause a surgical strike against pemphigus in Dermatology World.

Related Links:

CMS eases up on value-based payment focus

The Centers for Medicare and Medicaid Services (CMS) has announced that it will not be following the timeline set by the Obama Administration to increase the percentage of Medicare payments that are tied to quality of care. In early 2015, the U.S. Department of Health and Human Services pledged to move 30 percent of Medicare provider payments from fee-for-service to alternative payment models by 2016, and 50 percent by 2018. Raymond Thor, spokesperson for CMS stated, “The Trump administration’s focus has not been on a specific targeted number by the previous administration, but rather on evaluating the impact of new payment models on patients and providers.”

Although the Administration is easing up on the value-based payment focus, the Merit-based Incentive Payment System (MIPS) remains in place. Find out what your colleagues are doing to prepare for MIPS reporting this year in Dermatology World.

Plan on submitting data for the 2017 MIPS performance period? Mark your calendars with these important deadlines:

  • March 1: Deadline for final claims to be processed for the 'Quality' category through Medicare Administrative Contractors. Claims reporting is only available for individual eligible clinicians. 
  • March 16 at 8 pm ET: Deadline for 2017 data submission for groups reporting via the CMS web interface.
  • March 31: Deadline for 2017 data submission for all other MIPS reporting, including via qpp.cms.gov.

Related Links:


Do EHRs reduce administrative costs?

According to results from a study published in JAMA, electronic health records (EHR) may not lower administrative costs. Researchers conducted a time-driven, activity-based costing study in a large academic health care system with a certified EHR system by interviewing health system administrators and physicians to calculate the cost for each major billing and insurance-related activity. The results showed that the estimated costs of billing made up 14.5% of professional revenue for primary care visits, 25.2% for emergency department visits, 8% for general medicine inpatient stays, 13.4% for ambulatory surgical procedures, and 3.1% for inpatient surgical procedures.

Considering investing in a new EHR system? Don't break the bank! Read more about the questions you should ask before adopting new technology in Dermatology World

Related Links:

Laser treatment may improve nail psoriasis severity

A recent study published Dermatologic Surgery indicates that treatments with the long-pulsed 1,064-nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser may improve severity of nail psoriasis. Sixteen patients with isolated nail psoriasis or nails with mild cutaneous involvement were treated with the long-pulsed 1,064-nm Nd:YAG laser for three sessions once per month. Patients experienced a statistically significant decrease in Nail Psoriasis Severity Index (NAPSI) scores in the nail bed and matrix.

In addition to lasers, new small molecule drugs are making a splash in nail psoriasis and other dermatologic conditions. Read more in Dermatology World.

Related Links: