By Bruce A. Brod, MD
Dermatology made progress in states across the country this year on our state policy priorities, which were identified by the AADA State Policy Committee and approved by the AADA Board of Directors, at the start of the year. Ten states were able to pursue advocacy initiatives with the assistance of AADA state advocacy grants.
Tanning ban for minors
In years to come, 2013 may be viewed as a tipping point in preventing future cases of skin cancer in minors. The commitment and perseverance of a coalition representing both physicians and patients led to the enactment of youth access bans in seven states. Four of the states enacted legislation that protect minors under 18 (Illinois, Nevada, Oregon, Texas), two states protect minors under 17 (New Jersey and Connecticut), and West Virginia and the District of Columbia banned minors under 14 from indoor tanning. As a result, forty states, including the District of Columbia, regulate the use of indoor tanning devices.
Building upon the success of the AMA Scope of Practice Partnership’s (SOPP) truth-in-advertising campaign, of which AADA is a Steering Committee member, state dermatology societies were instrumental in passing legislation in four states that will assist patients in identifying who is providing their care. Maine, Maryland, Texas, and Nevada increase the total to fourteen states that have enacted truth-in-advertising legislation since the SOPP’s campaign began. Working with members of the SOPP, the AADA successfully opposed a scope of practice bill in Illinois and California that would have jeopardized patient safety by weakening physician-led team care. Legislation in both states would have authorized nurse practitioners to practice independently.
Biosimilars and pharmaceutical safety
Advocating for patient access to pharmaceuticals, AADA and several state dermatology societies submitted comment letters regarding the substitution of biosimilars. A main concern for dermatologists is that pharmacists notify the physician of the substitution by the time of dispensing. Pharmaceutical safety was also a hot topic for 16 states. States introduced legislation or proposed regulations, varying in their approach, in response to last year’s meningitis outbreak resulting from contaminated drugs from a compounding pharmacy. The AAD Board of Directors adopted a position statement on compounding this year that will guide next year’s efforts as this issue will certainly continue to be debated at the state level.
October saw the opening of the Accountable Care Act-mandated health exchanges. The management of the exchanges varies by state, with some managed by the state alone, some by the federal government, and other through a joint federal-state effort. The AADA will continue to monitor exchange implementation and its effects on the specialty once the coverage begins in January 2014.
Planning for 2014
State societies are encouraged to review the AADA’s state advocacy resources as you begin preparation for 2014. The Academy recommends that state societies actively encourage their members to reach out to state legislators prior to the legislative session and educate them on issues affecting the specialty. This type of outreach is a great way to build a relationship and establish dermatologists in the state as trusted health care experts available to answer lawmakers’ questions about the implications of health care bills during the busy legislative session.
Members who have any questions concerning state advocacy are encouraged to contact Lisa Albany, assistant director of state policy at email@example.com or (202) 842-3555.
Dr. Brod is chair of the AADA’s State Policy Committee, and he also serves as advisor to the AADA's State Society Development Task Force. He is a clinical associate professor of dermatology at the University of Pennsylvania Perelman School of Medicine.