Medical research funding and patient access to treatments

AADA pushes for NIH funding increase in 2015

As a member of the One Voice Against Cancer (OVAC) coalition, the AADA sent a letter to the chairs and ranking members of the Congressional appropriations committees, urging them to restore cancer research and prevention funding at the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) to pre-sequestration levels.

AADA and OVAC recognize that the nation’s research infrastructure is on the brink of remarkable and potentially life-saving cures and treatments for patients with cancer. But significant budget cuts to NIH and CDC have slowed the pace of progress, leaving in its wake promising research proposals that could offer life-saving and life-improving cures and treatments.

AADA applauds AMA action to help patients maintain access to providers

At its 2014 House of Delegates meeting, the American Medical Association (AMA) called for legislation or regulation to address inadequate provider networks for health plans. The AADA sounded the alarm earlier this year on the downstream effect to patients as a result of narrow networks. The AADA commends the house of medicine for advocating additional action to ensure patients receive meaningful, in-network access to specialty care. AADA, in conjunction with AMA and other specialty groups, continues to place pressure on insurers, lawmakers, and regulators to protect Americans’ access to a qualified physician.

The AMA position states that changes to provider networks must be communicated prior to enrollment periods, and that health plans must offer patients an accurate, complete directory of participating physicians, communicating any updates or changes through multiple channels.

The AMA resolution follows on the heels of AADA testimony before the Medicare Payment Advisory Commission (MedPAC), imploring more oversight and transparency for insurance company network policies. MedPAC is the independent body tasked with advising Congress on Medicare policy.

As evidence of the growing network adequacy issues, a new JAMA Dermatology study found on average, only one quarter of physicians listed in the insurance providers' directories were non-duplicates, could be reached at the given contact information, and were able to offer an appointment.

AADA supports greater funding for NIH research

AADA is advocating for an increase to appropriations for the National Institutes of Health (NIH) with its support of the Accelerating Biomedical Research Act (H.R. 5580), a bill authorizing Congress to fund NIH beyond current spending caps.  The proposed legislation, and its companion bill in the Senate, has received widespread support from the medical, scientific and patient communities. In its letter of support to Reps. Rosa DeLauro (D-Conn.) and Brian Higgins (D-NY), AADA states, “Budget cuts and fiscal pressures have had a direct impact on current and future research projects, potentially limiting our patients’ access to life-saving treatments and cures of the future. To ensure that the research being supported today yields the breakthroughs of tomorrow, sustained funding is critical to achieving long-term and permanent treatments and cures.” Read the AADA's letter of support.

AADA supports increased funding for NIH biomedical research

The AADA offered its support for S. 2658, the Accelerating Biomedical Research Act, that allows for an increase in funding for the National Institutes of Health (NIH) by adjusting the discretionary budget caps mandated by the Budget Control Act. The Academy commended Senator Tom Harkin (D-IA) for introducing this legislation, which would allow the Appropriations Committees to restore the funding level the NIH would have had if the agency’s funding level kept pace with inflation. The AADA noted that sustained funding is critical to achieving long-term and permanent treatments and cures. Read the AADA’s letter of support

AADA comments on use and availability of health care data

The AADA submitted a letter to the Senate Committee on Finance in response to its inquiry about the use and availability of health care data. Specifically, the Committee is seeking input regarding what data sources should be made more broadly available, as well as how data should be released and used. The Academy supports the release and sharing of meaningful and reliable health care data to help physicians improve the care provided to their patients, and to allow patients to make better decisions about their health and health care. However, it suggested that data must be released with appropriate context in order to be useful. The AADA called for more data on outcomes and quality measures to be developed, reforms to improve accessibility and usability of health care data, and noted barriers to using existing data sources. Read the AADA's comment letter on health care data.

AADA raises concerns about naming of biosimilars to FDA

The AADA joined other physician specialty groups to raise concerns about the naming of biosimilars as outlined in the Biologics Price Competition and Innovation Act to the U.S. Food and Drug Administration (FDA). The AADA urged the FDA to develop guidance for biosimilars that would ensure distinct nonproprietary names for the biosimilar product. The AADA is advocating for a naming system that will help to alert physicians that each biosimilar product, while safe, effective, and highly similar to the brand biologic product, will differ slightly. Using distinguishable names will help prevent inappropriate pooling of adverse events by clearly identifying which product a patient was prescribed.

Dr. Brenda Dintiman testifies at Congressional hearing on telemedicine

Brenda Dintiman, MD, testified before the House Small Business Committee’s Subcommittee on Health and Technology on July 31 about the barriers of implementing telemedicine as a modality of care. Teledermatology is viewed as a valuable means of improving patient care to underserved patients with limited access to specialty care, a triage tool to determine which cases must be seen in person most urgently, or a platform to deliver care to individuals unable to receive the benefits of face-to-face dermatology visits. However, lack of reimbursement and cumbersome credentialing pose the greatest challenges to using telemedicine most effectively, Dr. Dintiman said. Although some reimbursement exists, it is not consistent across payers or states to allow for proper patient access. Without assured reimbursement, she said,providers and patients are unlikely to utilize telehealth. Congress can help set the stage for larger-scale reimbursement by, for example, enabling Medicare to reimburse for telemedicine services, Dr. Dintiman said, noting that many large health systems including the Veterans Affairs and Kaiser Permanente reimburse for these services. With regard to credentialing, the Interstate Medical Licensure Compact proposed by the Federation of State Medical Boards would make it easier for doctors to be licensed in multiple states. While Dr.Dintiman has faced these barriers herself, she noted that it is ultimately the patients — often the most economically vulnerable — who are most directly affected when physicians are unable to provide effective and efficient care via telemedicine. Read Dr. Dintiman’s testimony.

House passes Sunscreen Innovation Act to expedite approval process for new sunscreen ingredients

The Academy applauds the House of Representatives for amending and passing H.R. 4250, the Sunscreen Innovation Act, which will ensure that sunscreen ingredients are thoroughly and expeditiously reviewed in a timely manner by the U.S. Food and Drug Administration (FDA). The AADA supports allowing the Nonprescription Drugs Advisory Committee (NDAC) to provide recommendations on sunscreen ingredients to the FDA. It also is pleased to see a provision under the amended bill that would allow the Secretary of Health and Human Services to appoint members of other federal advisory committees or outside consultants with substantive expertise to the NDAC when sunscreen ingredients are reviewed. Additionally, the AADA favors the amended provisions that strengthen Congressional oversight by requiring reporting of the FDA’s activities and progress in the review of sunscreen ingredients. Read the AADA’s letter of support

Sunscreen Innovation Act

The AADA has issued a letter of support for H.R. 4250, the Sunscreen Innovation Act, which would expedite the FDA’s approval process for new sunscreen ingredients while maintaining strict safety standards. In particular, the AADA supports allowing the Nonprescription Drugs Advisory Committee (NDAC) to provide recommendations on sunscreen ingredients to the FDA. The AADA is also pleased to see a provision that would allow the Secretary of HHS to appoint members of other federal advisory committees — or outside consultants with substantive expertise regarding sunscreen active ingredients — to the NDAC when sunscreen ingredients are reviewed. The AADA is also pleased that the bill includes provisions that strengthen Congressional oversight by requiring reporting of FDA’s activities and progress in the review of sunscreen ingredients. Read the AADA’s letter of support.

Medical research funding

Research helps reduce the incidence and the death rate attributed to skin cancer, and decreases health care costs overall. The AADA is calling on Congress to end sequestration and increase medical research funding. 

  • Medical research funding and access to treatment background information.
  • In July 2014, the AADA joined with the One Voice Against Cancer (OVAC) coalition for an advocacy day on Capitol Hill to educate members of Congress and the Senate about the importance of federal funding for cancer research and prevention programs. The group — which included 25 national and state organizations representing millions of health care providers, patients, survivors, public health professionals, scientists, caretakers, and their families — visited the offices of 131 key members of congress.
  • The AADA signed on to a coalition letter with the American Association for Cancer Research and more than 100 other groups calling on House and Senate leaders to make cancer research and biomedical science a national priority by providing at least $32 billion for the NIH and $5.26 billion for the National Cancer Institute (NCI) in FY 2015. Read the coalition letter.
  • Read the AADA letters to the House and Senate chairs and ranking members of the Appropriations Subcommittees on Labor, Health and Human Services, Education, and Related Agencies in April 2014.
  • The AADA signed on to letters from the One Voice Against Cancer (OVAC) coalition requesting more medical research funding in FY15. Read the letters to the House and the Senate in April 2014.

Academy action on network adequacy and transparency pays off

After collaboration with the American Academy of Dermatology Association (AADA), Rep. Rosa DeLauro (D-Conn.) and Sens. Sherrod Brown (D-Ohio) and Richard Blumenthal (D-Conn.) have introduced the Medicare Advantage Participant Bill of Rights Act of 2014 (HR 4998/S 2552) that would enhance beneficiary and physician protections, and improve transparency in the Medicare Advantage (MA) networks. Specifically, beginning in plan year 2015, the bill ensures that provider networks cannot be changed mid-year by terminating physicians without cause, and that networks will be finalized before open enrollment begins. This legislation does not prevent networks from dropping physicians without cause altogether, however it discourages it. Read more about the legislation.

The AADA was the first national physician organization to issue letters of support for this legislation. Read the AADA's letters of support to Rep. DeLauro and Sens. Brown and Blumenthal.

Academy offers first-hand expertise on telemedicine to House Energy and Commerce Health Subcommittee

In response to a request for comment, the AADA sent a letter to the House Energy and Commerce Health Subcommittee offering insight on the use of technology to advance the nation’s health care system and improve patient care. The AADA showcased teledermatology programs, AccessDerm and Inpatient TeleDerm, as well as the opportunities and challenges facing teledermatology. Read the AADA's letter on telemedicine.

Congressional hearing on telemedicine
In an effort to examine how technology and telemedicine can advance efficiency, quality, and access to health care, the U.S. House Subcommittee on Health held a hearing on telemedicine on May 1, 2014. Carrie L. Kovarik, MD, FAAD, chair of the AAD Telemedicine Task Force submitted a written statement on behalf of the Academy for this hearing.


USPSTF research plan on skin cancer

The United States Preventative Services Task Force (USPSTF) issued its draft research plan on skin cancer. The AADA issued a letter to the USPSTF urging the Task Force to expand its skin cancer research settings to include dermatology visits and screening programs, and not just primary care sites of service. The AADA also urged the Task Force to expand the scope of the research plan on skin cancer to include adolescents and young adults. Read more AADA recommendations to the USPSTF.

Physician groups concerned compounding law will impact patient access to treatments

The AADA - along with several other physician groups - has expressed concerns to the FDA regarding the agency's implementation of the Drug Quality and Security Act as it relates to in-office use. Physicians have reported experiencing difficulty accessing both repackaged and compounded drugs without a prescription for in-office use. Physician groups are calling on the FDA to implement the law the way Congress intended which was to protect physician and patient access to compounded drug products. Read the letter.  

Provision in Public Health Services Act could expand non-physician scope of practice, diminish network adequacy

The “Non-Discrimination in Health Care Providers” provision in the Public Health Service Act prevents group health plans and health insurance companies from discriminating against any health care provider who is acting within the scope of that provider’s license or certification under applicable State law.

However, in some cases, this provision has allowed health professionals to expand their scope of practice under state law. These efforts could impair patient quality of care, therefore, the AADA is urging CMS to interpret this provision in a way that supports state scope of practice laws and asks CMS to support congressional efforts to repeal this provision.

Additionally, the AADA expressed concerns that an interpretation of this provision — which would allow discrimination against providers in reimbursement rates based on broad “market considerations” — could further exacerbate the issue of narrowing networks. Insurers could interpret the provision as a means to exclude whole categories of providers which could impede patient access to dermatologic care.

Read the AADA’s letter to CMS.

Pathology Services

H.R. 2914, the Promoting Integrity in Medicare Act of 2013, would limit patient access to in-office services that physicians provide under the physician self-referral or Stark law. 

  • Read a coalition letter opposing H.R. 2914.
  • The AADA and several other physician groups have joined Rep. Phil Roe, MD, (R-Tenn.) in calling on Speaker of the House Rep. John Boehner (R-Ohio) and Rep. Nancy Pelosi (D-Calif.) to preserve physicians’ abilities to provide in-office ancillary services such as pathology. Read the letter from Rep. Roe, the AADA, and other physician groups.
  • The AADA signed on to a coalition letter to all members of the Senate Health, Education, Labor and Pensions Committee and Finance Committees, and to all members of House Ways and Means and Energy and Commerce encouraging them to request that the Office of the Inspector General exempt pathology providers from the safe harbor rule. Read the coalition letter.

Physician workforce shortage

With a physician workforce shortage projected to reach130,600 physicians in 2025, the AADA and other specialty societies are calling on Congress to protect Medicare beneficiary access to health care services by preserving existing Medicare financing for Graduate Medical Education (GME). Medicare’s current cap on financial support for GME prevents teaching hospitals from expanding the number of training positions and often prevents new hospitals from establishing teaching programs. In a joint letter, the organizations stressed that Medicare GME cuts will threaten access to care for millions of current and future patients. Read the AADA letter.

Drug approvals, warnings, recalls and shortages

The Academy works with the FDA to stay abreast of the latest actions that affect patient safety and access to dermatologic  drugs.

Physicians across the country have expressed concern regarding the ongoing shortage of vital drug products. Unfortunately, drug shortages are affecting every medical specialty, including anesthesia, oncology, emergency medicine and dermatology. The Academy continues to work with FDA officials to resolve drug shortage issues.


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