By Ronald L. Moy, MD, AADA President, March 01, 2011
Last year’s health system reform law raises many concerns for dermatologists. Your American Academy of Dermatology Association knows that, and we are working on many fronts to address those concerns, pressing Congress for legislative adjustments, making our voice heard at the agencies that implement the law, and ensuring that members understand how coming changes will affect them.
On the legislative front, we face a challenging political landscape. The Republican-controlled House of Representatives favors full repeal of the Patient Protection and Affordable Care Act; a Democratic Senate and the reality that President Obama will remain in office at least until 2013 mean, however, that any changes to the law in the short term will need to be bipartisan and made bit by bit.
To that end, we are actively engaged with Congress. Legislation has been introduced to repeal the Independent Payment Advisory Board, described earlier in this issue, and we are working with Congress to make a concerted effort to craft legislation that garners bipartisan support in order to secure passage. Our Washington staff is also involved in leadership meetings with the House Republicans to discuss how to address the Medicare physician payment issue. As additional pieces of legislation to improve the reform law are proposed, we will remain engaged, evaluating their impact on dermatology and supporting changes that would benefit our practices and our patients.
We’ve also been actively participating in talks with the administration about how the reform law will impact us. The chair of our Council on Government Affairs, Health Policy and Practice, Jack Resneck Jr., MD, attended a White House meeting on Nov. 15, 2010 to discuss reform; former president David Pariser, MD, and current Secretary-Treasurer Robert Greenberg, MD, represented us at a subsequent meeting with the administration on Dec. 17. These meetings discuss important issues at a very high level — they are not the place to get into the nitty-gritty details of reform. But they give us the opportunity to increase awareness of dermatology’s concerns and the needs of small and solo practices.
Meanwhile, the process of implementing the reform law has begun. The Department of Health and Human Services, the Centers for Medicare and Medicaid Services (CMS), the Agency for Healthcare Research and Quality (AHRQ), and the Food and Drug Administration all issue proposed regulations related to both the reform law and other important matters; recently, they have been engaging stakeholders earlier in the process through town hall meetings and requests for information prior to rulemaking. The Academy engages with these agencies through the submission of comment letters, attendance at meetings and town halls, and presentations made at open public forums. The new Centers for Medicare and Medicaid Innovation will create a new area within CMS where we can raise ideas about payment reform that will be good for the practice of dermatology and for dermatology patients. [pagebreak]
We are also engaged with the Medicare Payment Advisory Commission, or MedPAC, a body whose recommendations often guide congressional debate about Medicare payments and policy. Academy staff attend the body’s quarterly meetings, disseminate information about them to the Academy’s committees to ensure that we are kept informed, and communicate directly with MedPAC staff on specific subjects of particular importance, such as the in-office ancillary service exemption policies discussed in MedPAC’s March 2010 Report to Congress. We have also nominated dermatologists for roles in MedPAC, as well as the Workforce Commission, the AHRQ National Advisory Council, and many other panels where they would represent the specialty’s particular concerns.
Those concerns are also represented on the AMA Relative Value Update Committee, where a team of dedicated volunteers and staff ensure that dermatology’s voice is heard as decisions about how to value the services we provide are made. Thank you to Brett Coldiron, MD, Scott Collins, MD, Daniel M. Siegel, MD, Glenn Goldman, MD, Fitzgeraldo Sanchez, MD, and Mark Kaufmann, MD, for their work on behalf of dermatology.
There are many ways that you can get involved in the political process, too. One of the quickest is to contribute to SkinPAC, the AADA’s political action committee. Together our contributions increase dermatology’s influence. You can learn more and contribute at www.skinpac.org.
As the process of revising and implementing health reform continues, the Academy will be well-served by the fact that our volunteers and staff are plugged into the process in so many different ways. You’ll also be well-served by the information we’ll provide to help you deal with the coming changes. Articles in Dermatology World will highlight new regulations and how they might affect dermatologists, with in-depth features explaining different components of reform. And you can always visit our online Health System Reform Resource Center at www.aad.org/hsr; it includes a wealth of information about the new law and how it will affect you along with the latest updates.