Currently working with multiple partners to pass a bill in the state legislature restricting tanning bed use for minors. Last year house bill 2493 was sponsored by the state house health committee but was never given a hearing. This year we hope to have a coalition of partners including the American Cancer Society, Arizona State Medical Society, Arizona Cancer Center, Tucson and Phoenix Dermatology Societies to move forward our efforts. We will again be engaging lobbyists and have a pro bono lobbying group (the Reister Marketing Group) that has expressed the desire to try to again have a bill be sponsored, discussed, and ideally passed by our state legislature in the upcoming session in 2016. In addition there is a national Congressional house bill (HR bill 2698) that has been presented to REPEAL the tax on tanning bed use thus removing disincentives and encouraging more tanning bed use. We have presented our unified outrage of having this pass and have lobbied our US congressional representatives to vote against this measure.
We have also had one of our members, Dr Tony Nuara actively engaged in producing a grass roots petition through “change.org” to get Dermatologists, other physicians and ultimately all citizens of the state who are interested in this issue to sign on and support this cause.
There have been several states which have passed legislation to limit the use of Laser devices to fully trained medical personnel and not allow poorly trained, and largely unsupervised providers use medical devices on patients without direct on-site physician supervision. California has recently passed such legislation. While our state, through the Arizona Radiation Regulatory Agency does have regulations to limit the use of Laser devices (for non-hair removal aesthetic purposes) such that they are to be performed under direct physician supervision, there is essentially no enforcement of these rules.
The current climate of our state legislature is such that bringing this issue to the attention of our legislators at this time is thought not to be productive. Currently we will be focusing our efforts on other issues that have a greater chance of being successful.
US Senate bill 1406 – “Saving Access to Compounded Medications for Special Needs Patients Act”- promotes the use of safe compounding in a physician’s office and ensures access to critical and unique medications.
US House bill 1600– “Patients’ Access to Treatment Act” Which limits cost-sharing requirements applicable to drugs in a new specialty tier (typically tier III) and diminishes cost barriers to effective medications
There is also a AAD task force on Drug costs and transparency which we will be working with at the state level to assure medications are available in a cost effective manner for our patients and to understand and influence the rising costs of both specialty and generic medications, and to help make them more affordable for our patients.
This effort is to address health plans narrowing of physician networks and supporting transparency in the process of evaluating physicians in their networks
Medicare Bill of rights Act will be presented in the US Senate in the next session and we will be following these issues closely as they can effect physicians being restricted from various health plan networks which can result in loss of continuity and poorer quality of patient care.
The FSMB, ABMS, AMA and CMS strongly support MOC and the Interstate Medical Licensure Compact (IMLC). The IMLC requires MOC for non-grandfathered physicians seeking licensure through the Compact. In addition, under the Compact, the situs of medical care is defined as where the patient resides rather than the physician, which could lead to physicians being sued for malpractice and having to defend the suit in another state.
The Compact is essentially a push to federalize physician licensure. MOC is a costly and time-consuming burden for physicians already in burnout mode due to administrative demands imposed by EMR, PQRS, Meaningful Use, and ACA. A July 2015 cost analysis of MOC in the Annals of Internal Medicine revealed an average cost per physician of $23600 over a ten year cycle of MOC with a cumulative cost of $5.7 billion. A December 2014 article in JAMA demonstrated no improvement in patient outcomes with MOC.
The American Gastroenterological Society, American College of Rheumatology and the American Board of Anesthesiology have criticized MOC for failing to meaningfully assess physician competence and the lack of evidence that patients are benefiting from their involvement with it. – See more at: http://www.rheumatology.org/About-Us/Newsroom/Press-Releases/ID/673/American-College-of-Rheumatology-Issues-Physician-Driven-Position-Statement-on-ABIMs-Maintenance-of-Certification-Requirements#src=social
The AAD has clarified its position on MOC in its letter of October 8, 2015, which in pertinent part states “The Academy is opposed to any licensing and credentialing requirements that mandate MOC. MOC should not be mandatory, but available to those who want to participate in this educational exercise. The Academy asserts that the vast majority of dermatologists should be able to accomplish most MOC requirements by actively practicing dermatology and by attainment of CME credit through participation in annual, regional, state, and local dermatology meetings, as well as other forms of CME (online, journal articles, quizzes, etc.).”
The Association of American Physicians and Surgeons (aapsonline.org) opposes MOC and the IMLC and has sued ABMS in federal court for restraint of trade. This suit is alive and is awaiting a ruling by a federal district judge in Chicago. AAPS is considering additional legal strategies to stop MOC. Grassroots efforts by physicians to oppose the MOC behemoth include http://www.changeboardrecert.com and the “Anti-MOC Campaign” see http://www.communitysynergy.com/cc/public/display/008c0d914a. See also dermatology petition to end MOC: https://www.change.org/p/american-academy-of-dermatology-immediately-remove-all-maintenance-of-certification-moc-requirements-for-dermatologists-who-have-passed-the-american-board-of-dermatology-certification-exam-and-leave-in-place-the-more-reasonable-continuing-medical-edu
In addition, an alternative recertification board – the NBPAS (National Board of Physicians and Surgeons)- founded in 2015 by San Diego cardiologist Dr. Paul Tierstein is challenging the ABMS monopoly. The NBPAS is gaining traction in achieving recognition at a growing number of hospitals and has over 2500 diplomates. Details at https://nbpas.org/. A two-year recertification through NBPAS costs $169. It requires that physicians obtain initial certification through ABIM or one of its affiliated organizations, and it requires physicians to attend 50 hours of CME every 2 yrs without high-stakes testing.
Despite this opposition, eleven states (chiefly rural states) have passed the IMLC in rapid succession since January, 2015. On the other hand, the Compact has been rejected (at least for the moment) in Texas, Ohio, New York, Florida, Michigan, and Missouri.
Arizona Senator Kelli Ward introduced a resolution in February, 2015, to help prevent the intrusion of the IMLC in Arizona but the bill was killed in part due to lobbying efforts of the Arizona Medical Association against the bill.
Contact us and get involved or submit your ideas on how ADDSS may continue to influence legislative change to enhance the physician’s ability to care for the patients.
To provide a voice for all Dermatologists in the state of Arizona in matters relating to the practice of Dermatology. We will advocate for our fellow members and interact with our state legislators and regulators who oversee and govern the practice of medicine in the state.
Presented by Dr. Gerald Goldberg,MD current President of the ADDSS.
As current president I am writing on behalf of the Arizona Dermatology and Dermatologic Surgery Society (ADDSS). Our Society is very young. With the help of the AAD it was formed 5 years ago. Advocacy was the motivating force in the creation of ADDSS. Arizona dermatologists wanted a voice. We knew we needed a state society to have our voices heard.
Our Plan and Budget
Our main goal this next year is to pass legislation to prohibit minors from indoor tanning in the state of Arizona. Because of the ground work we have laid, the FDA’s proposed reclassification, and support from other national and regional medical societies I think it is a very achievable goal. We have a “three prong” plan.