By Mark Lebwohl, MD, July 01, 2015
With the signing of the Medicare Access and CHIP Reauthorization Act, one of medicine’s most threatening nemeses — the sustainable growth rate (SGR) formula — has been sent to the grave. This law has effectively ended a 13-year fight against massive cuts to Medicare physician payments, and stopped a debilitating CMS proposal that would eliminate global period codes. This is an incredible win for our specialty and our patients. However, these advocacy achievements did not come by chance. Without our staff in Washington, D.C., and the participation of our active Academy members, these advocacy achievements would not have been possible.
When the debate on SGR repeal and Medicare payment reform was in full swing, our Washington, D.C. office sent countless emails encouraging Academy members to take a moment and send a letter to Congress in support of the legislation. It only took about a minute to log on to the Academy’s Dermatology Advocacy Network, click on the link provided, check a box, and hit send. As a result of this seamless process, Academy members sent a record-breaking 5,000 emails to their members of Congress supporting the legislation. I am certain that our specialty’s collective voice didn’t go unnoticed on Capitol Hill because there is no denying that the number of letters that Congress receives from constituents matters a great deal. In the future, when the Academy calls on you to write a letter to Congress, please take a minute and do so; staff has made it easy to do, and it truly makes a difference.
It should be noted that it was no small feat obtaining bipartisan support for this legislation. However, Reps. Larry Bucshon, MD (R-Ind.) and Ami Bera (D-Calif.) managed to get Reps. John Boehner and Nancy Pelosi to appreciate what the elimination of global periods would do to patients by convincing 53 other congressmen to write a group letter arguing against the cuts. I firmly believe that you can’t buy votes, but our Washington office has equipped us to access these policymakers and make our case heard. I encourage members to learn more about SkinPAC.
The repeal and replacement of the SGR formula, while a big win, is certainly not perfect. However, the bottom line is that dermatologists were facing a 21 percent cut overall. This would have been a huge income hit that would have affected our practices and our Medicare patients immediately. Additionally, if the global periods had been eliminated, the only winner would have been the insurance companies because where Medicare goes, the private payers follow. In the end, the big losers would have been the patients who would have been forced to pay multiple copays for the same procedure. The concerns we have with the new law are issues that we can always work on going forward, now that we have room to breathe and a seat at the bargaining table. The AADA’s 2015 Legislative Conference is coming up, Sept. 27-29, in Washington, D.C. This will be our specialty’s premier opportunity to sort out some of our concerns. I encourage everyone to register today.
Like many Academy presidents before me — and probably like many Academy members — I used to have no idea what the value of a Washington, D.C. office was. I used to think it was a waste — we’re a small specialty, so we should be careful about what we spend our money on. However, I — like every president who has come before me — now realize that without the D.C. office and its tireless work to fire up the member-advocacy machine, the specialty and its patients would be much worse off than we are today.