New leaders needed to leverage successes of past year

lebwohl-mark.jpgBy AAD President Mark Lebwohl, MD

On March 5, voting opens for the 2016 AAD election. As we prepare to select a president-elect and board members, I’d like to take a moment to reflect on achievements earned by our specialty over the past year.

Repeal of SGR and preservation of global periods

The hallmark achievement of 2015 was the repeal of the sustainable growth rate (SGR) formula. For over a decade, the Academy’s advocacy team along with other specialties fought to repeal SGR, and in April 2015, our efforts finally paid off. With the signing of the Medicare Access and Children’s Health Insurance Program Reauthorization Act (MACRA), we saw the end of this unsustainable Medicare payment mechanism.

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The law ended an era of SGR fixes and patches that for far too long left Medicare beneficiaries wondering about their ability to access quality dermatological care. It also averted massive cuts to Medicare payments, replacing a threatened 21.2 percent cut to Medicare reimbursements with a 0.5 percent annual payment increase through 2019.

Through this legislation, we also stopped a debilitating CMS proposal that would have eliminated 10- and 90-day surgical global payment codes and would have hurt dermatologists and their patients more than any other specialty.

With the SGR charade behind us, physicians have an added measure of practice stability that will enable us to more closely focus on meaningful physician payment and delivery reforms that facilitate access to high quality patient care.

Other notable achievements

  • The American Academy of Dermatology Association (AADA) convened the Task Force on Drug Pricing and Transparency, which is working to increase drug ricing transparency so patients can get the access to the treatments they need. The task force has been instrumental in introducing step therapy legislation and cap-on-copay legislation in multiple states. The task force has also produced resources for dermatologists to help their patients find ways to pay for their medications.
  • In 2015, the AADA was instrumental in pushing legislation that impedes insurance step-therapy policies that require patients to fail a cheaper drug before being allowed to use a more expensive, but sometimes more effective drug. So far, seven states — California, Connecticut, Kentucky, Louisiana, Maryland, Mississippi, and Washington — passed legislation addressing this critical access issue by authorizing prescribers to seek an exception or request a substitution.
  • The Academy remains the leader in pushing for state-based indoor tanning restrictions. In 2015 alone, the Academy successfully pushed for a ban on indoor tanning for minors under the age of 18 in two states — New Hampshire and North Carolina — bringing the total number of states with an under-18 ban to 14 (including the District of Columbia). Additionally, Connecticut, New Jersey, New York, and Pennsylvania have passed legislation banning minors under the age of 17 from using tanning devices. On the national level, we are working diligently to support the FDA’s decision to restrict indoor tanning by minors and increase warnings to adults about the dangers of indoor tanning. I urge all members to submit a letter supporting the FDA’s decision.
  • Most of our achievements are the result of the diligent efforts of our advocacy team, which receives support from SkinPAC, the American Academy of Dermatology Association’s political action committee. I’m pleased to report that this has been a record-breaking year for SkinPAC. Thanks to contributions from dermatologists like you, we surpassed our fundraising record from the 2013-2014 election cycle.

Challenges in the coming year

I am proud of all that the Academy has accomplished in the previous year, and I am confident that we can be just as successful on the critical issues we’re now facing:

  • We must advocate for the enactment of federal legislation known as the Patients’ Access to Treatments Act (PATA) that would limit cost-sharing requirements for specialty drugs. If enacted, PATA would help protect patients’ access to treatments by limiting the patient’s portion for medications in the specialty drug category to the co-pay amount for drugs in lower tiers.
  • Because of federal budget cuts in recent years, medical research hubs like the National Institutes of Health (NIH) have seen the funding well almost dry up. Just over the last 10 years, funding for the NIH has dropped by more than 22 percent when adjusted for inflation. We must continue to support legislation such as the 21st Century Cures Act that would give the NIH $8.75 billion in additional mandatory funding and provide the Food and Drug Administration an additional $550 million to support reforms intended to modernize the drug and medical device approval process.
  • We need to address the issue of narrowed provider networks in Medicare Advantage (MA) plans and ask Congress to take up the Medicare Advantage Bill of Rights Act, which would improve transparency in the MA insurance market by establishing network access adequacy standards, limiting the ability of plans to remove providers mid-year, and ensuring patients can continue to get care when a provider is terminated from a network plan.
  • We need to continue to urge the American Board of Dermatology (ABD) to make essential changes to the MOC program, which continues to frustrate a significant number of our members. In response to growing member frustration about MOC, the Academy sent a letter to the ABD in 2015 asking for changes to the MOC program. We summarized the findings of a recent survey of Academy membership on the perceived value of MOC. More than 3,000 of our members responded to this survey, and you made it abundantly clear that change is needed in MOC.  Armed with this information and working with today’s ABD leadership that wants to make MOC less onerous, we are optimistic that we can influence the ABD to make constructive changes that benefit our members and their patients.

Meet the candidates

Dermatology is facing many challenges in the year ahead, and we need strong leaders to strengthen the specialty. The Academy recently announced the slate of candidates in the 2016 election. This is your opportunity to meet the AAD candidates who will help lead the specialty in the coming years. I encourage all members to visit the AAD election site to learn more about the candidates and to use the AAD Town Hall to ask questions about where they stand on important issues.