Advocacy Update Feb. 11, 2025
IN THIS ISSUE / Feb. 11, 2025
AADA urges members to oppose physician assistant independent practice legislation
AADA opposes Regence Blue Cross Blue Shield payment reduction
Medicare Payment
Act now to stop Medicare payment cut
On Feb. 3, AADA President Seemal R. Desai, MD, FAAD sent out a President’s Message with an action alert encouraging AADA members to urge their representative to cosponsor H.R. 879, the Medicare Patient Access and Practice Stabilization Act. This bipartisan legislation would stop the Medicare physician payment cut that went into effect on Jan. 1 and provide physicians with an additional 2% payment increase for 2025. Only 8% of AADA members contacted Congress last year — we need your help to spread the message to Congress on how this impacts health care access. If you have not done so already, please visit the AADA Action Center to contact your representative.
Please also share this message with your colleagues in your networks, communities, and home states and urge them to take action.
Scope of Practice
AADA urges members to oppose physician assistant independent practice legislation
South Dakota dermatologists asked their state representatives to reject legislation that would authorize physician assistants to practice medicine independently after completing 2,080 hours of collaboration. The AADA joined efforts led by the South Dakota State Medical Association, including financial assistance through the Scope of Practice Partnership (SOPP). The Scope of Practice Partnership is comprised of 105 national, state, and specialty medical associations that work together to ensure physician-led team-based care, in which the AADA is a Steering Committee member. The South Dakota House Health and Human Services Committee passed the bill despite strong opposition from the medical community. It now heads to the full House for consideration.
Payer Advocacy
AADA opposes Regence Blue Cross Blue Shield payment reduction
The Academy — along with state dermatology societies in Idaho, Oregon, and Washington — demanded that Regence Blue Cross Blue Shield (BCBS) not enforce the carrier’s recent modifier 25 policy change that would reduce payment by 50%.
In a coordinated advocacy effort led by the AADA, the multi-signatory letter opposed this modifier 25 policy change (PDF) effective March 2025. If implemented, the carrier will reduce payment by 50% for the E/M service when reported with a minor procedure. The AADA organized a strategic response with state medical and specialty societies in the affected states and several responded directly to Regence BCBS as well.
Payer Advocacy
Dermatologists demand Aetna cover psoriasis treatment
The AADA demanded that Aetna reconsider its 2025 formulary change that would remove the entire class of IL-17 inhibitors that treat psoriasis. The change would be effective March 1, 2025.
The AADA sent a letter to Aetna (PDF) objecting to its planned formulary change that would remove the entire class of IL-17 inhibitors for the treatment of psoriasis and only cover IL-23 inhibitors. While some would remain for psoriatic arthritis treatment, the carrier’s policy would require that those currently being treated with the IL-17 class for psoriasis either switch or go through an appeal process and be subject to potential decreased level of coverage.
The AADA previously met with Aetna and will continue to address our concerns directly with the carrier.
Quality Payment Program
AADA insists CMS retain MA plan measures on appeals
The AADA is concerned by a CMS proposed regulation that would retire measures on insurance appeals.
In a letter asking CMS to retain the measures (PDF), the AADA implored: “Patients face significant barriers to treatment when Medicare Advantage (MA) and Part D plans use coverage and utilization management policies such as prior authorization and step therapy. These types of policies can delay the initiation or continuation of medically necessary treatments, which ultimately jeopardizes patients’ health and increases the risk of poor health outcomes.”
The AADA asked CMS to retain two measures regarding MA plans’ review of appeals as part of its Five-Star Quality Rating System. In its comment letter, the AADA cautions CMS that the measures on the appeals process are an important safeguard for patients, particularly those inappropriately denied care because of restrictive utilization management policies.
AADA News
Contribute to SkinPAC to support dermatology champions
As of Feb. 6, SkinPAC has raised $122,110 from 69 individuals. Help us start the new year and new election cycle strong by contributing to SkinPAC today! SkinPAC helps strengthen our relationships on Capitol Hill and reinforces our grassroots and lobbying efforts.
Contribute online at www.skinpac.org or by texting SkinPAC to 71777. Email skinpac@aad.org with any questions.
The political purpose of the American Academy of Dermatology Association Political Action Committee ("SkinPAC") is to solicit and receive contributions to be used to make political campaign expenditures to those candidates for elective office, and other federal political committees, who demonstrate understanding and interest in the view and goals of the American Academy of Dermatology Association.
Contributions to SkinPAC are not deductible for federal income tax purposes. Contributions to SkinPAC must be made from your funds and may not be reimbursed. SkinPAC cannot accept contributions from corporate accounts. Any recommended contribution amount is merely a suggestion. All AADA members have the right to contribute more or less or refuse to contribute without reprisal. Federal law prohibits us from accepting contributions from foreign nationals. Federal law requires us to use our best efforts to collect and report the name, physical address, occupation, and name of the employer whose contributions exceed $200 in a calendar year.
