May 2

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IN THIS ISSUE / MAY 2, 2018


The clock is ticking: Only a few days left to review your Sunshine Act info

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Physicians have until May 15 to review and dispute the 2017 data that manufacturers and group purchasing organizations have submitted about them through the Open Payments program. CMS publishes information about the financial relationships between drug and device manufacturers and health care providers through the Open Payments program — also known as the Sunshine Act. Physicians can review their data by setting up an account and logging into the Open Payments website. Visit the CMS website for more information.

The Open Payments program represents the recent push to increase transparency in health care. While physicians are provided the opportunity to review their data and dispute it before the information goes live, some may be concerned that the reported information has the potential to be misinterpreted. Read more about the effects of data divorced from context in Dermatology World.

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PBMs cutting copay coupons from patient deductibles — which could mean soaring prices for your biologics patients

The battle between insurers and benefit managers who want to control costs and drug manufacturers ― who want to get their products in the hands of as many patients as possible ― has escalated this year as some insurers have quietly tweaked their policies around copay coupons. Using a technique variously referred to as a copay accumulator, benefit plan protection program, copay offset program, specialty copay card program, cost sharing payments, out-of-pocket promotion program, or accumulator adjustment program, insurers are not allowing the value of copay coupons offered by manufacturers to count toward patient deductibles. As a result, patients who might have paid a modest portion of their drug costs will now be required to pay the full amount of their deductible out of their own pocket. For patients with high-deductible insurance, this may make treatment unaffordable.

This trend is one of many that are making the drugs dermatologists prescribe more expensive and harder for patients to access. Read more about these purse-string policies in Dermatology World

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The latest cosmetic trend: Preventative Botox

According to a recent report on cosmetic trends, millennials are increasingly interested in getting preventative botulinum toxin injections. Since 2010, the number of botulinum toxin procedures conducted for patients 20 to 29 years old increased 28 percent.

Similarly, there has been an influx of dermal fillers approved by the Food and Drug Administration (FDA) in recent years. But these aren’t just any fillers. The latest fillers target moderate to severe wrinkles and/or folds in specific anatomic locations. Learn more in Dermatology World.

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CMS to change name of MIPS EHR section

The Centers for Medicare and Medicaid Services (CMS) has announced that it will be changing the name of the ‘Advancing Care Information’ section of the Merit-based Incentive Payment System (MIPS) to ‘Promoting Interoperability’. The Electronic Health Record (EHR) Incentive Programs for hospitals will also be called ‘Promoting Interoperability’ but does not combine the EHR Incentive Programs and MIPS.

How did your practice handle the first year of MIPS? How did others in the specialty fare? Find out in this month’s issue of Dermatology World. Is your practice up-to-date on 2018 MIPS claims-based reporting? Register for the Academy’s live webinar, MIPS and its Impact on Coding & Documentation, being held on May 17 at 12 p.m. CT. Save $25 with promo code MAYDWW2018.

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Want to know how much your patients’ prescriptions will cost? There’s an app for that.

Coming soon to an EHR near you: a tool that tells you how much your patients will pay for a drug out of pocket? Gemini Health, a health care technologies startup, has developed a tool that allows physicians to see patients’ out-of-pocket costs for drugs specific to their health insurance plan. According to the developers, the tool can be integrated into a practice’s EHR system and will be free for physicians and patients. Blue Shield of California will be testing the service in the next two months with 6,000 California physicians and is hoping to expand the service to physicians in 17 other states.

Physicians and their patients often have to jump through hoops to gain access to affordable drugs. Learn more about what’s happening with the cost of drugs in Dermatology World.

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2019 committee appointment application now open

Every year, hundreds of dermatologists serve the Academy through its organizational governance structure and through other service opportunities. The Appointment Selection Committee, chaired by George J. Hruza, MD, MBA, has begun accepting applications to fill 2019 open appointments. Applications must be submitted by June 30, 2018. Members who are selected to serve will be contacted in the winter. Letters of recommendation are highly suggested but are not required. 

Access the 2019 online appointment application at www.aad.org/applications/cctf. Learn more about the specific committees and task forces, committee member responsibilities, and other opportunities, in the CCTF Resources-Governance Handbook.