Bob Gatty

Dermatology has a committed ambassador in Capitol Hill, but it's tragic as to why. Rep. Brian Bilbray (R-Calif.) and his youngest daughter, Briana, both have been diagnosed with skin cancer and are speaking out about it to encourage others to prevent and detect skin cancer early. The congressman has co-sponsored the Melanoma Research Act of 2012, which would provide funding for skin cancer research.

Dermatologists who strongly oppose key provisions of the Patient Protection and Affordable Care Act (ACA), upheld by the U.S. Supreme Court in late June, continue to turn their attention to Congress in the hopes of obtaining some relief.

Two important Washington developments regarding sunscreen have taken place this summer, but neither will do much to help adults who need guidance in protecting themselves during this year's sunbathing season. Early in May, the Food and Drug Administration announced it is delaying until December implementation of new sunscreen rules that had been scheduled to take effect in June.

Although the risk of melanoma is especially high for youth and young adults who engage in indoor tanning, tanning salon workers across the nation have told congressional undercover investigators that indoor tanning is safe and the idea that indoor tanning can cause skin cancer is false.

The Senate on March 2 voted again to delay the 21.2 rate cut caused by the sustainable growth rate formula, delaying it to April 1. The extension should allow lawmakers to pass yet a third extension, this one reportedly slated for seven months, to give Congress more time to come up with a better solution.

Once again, dermatologists and other physicians face the prospects of huge reductions in their Medicare reimbursement rates because of the inability of Congress to resolve the problems imposed by the sustainable growth rate formula (SGR) and must count on, yet again, another temporary reprieve.

It has become increasingly likely that even if Congress approves some form of healthcare reform this year or early next, it will not include significant reform of the formula on which physician Medicare payments are calculated, which is disappointing news for dermatologists and every physician who serves Medicare patients.

As the healthcare reform debate unfolds, most of the headlines have focused on whether there would be a "public option" and, to a lesser extent, how the various proposals would affect Medicare, including patients and providers.

This month, the agency will complete its review of comments submitted regarding the adjustments.

At press time, lawmakers were still inching toward meeting a Sept. 15 deadline set by the Senate Finance Committee to reach a bipartisan compromise on healthcare reform. Dermatologists from across the country were expecting to be on Capitol Hill that day to let lawmakers know face-to-face their concerns about this sweeping legislative initiative.

With comprehensive healthcare reform moving through Congress, the American Academy of Dermatology (AAD) is urging lawmakers not to use Medicare as a model for any public health insurance option that may be included in the final plan.

As the Obama administration and the 111th Congress move forward on healthcare reform, there is increasing sentiment for greater support for primary care physicians, including boosting their Medicare payments. Unfortunately for dermatologists, they and other specialists could be asked to ante up.

Not long ago, a dermatologist from the southwestern United States who works in a busy six-physician practice received a check in the mail from the Center for Medicare and Medicaid Services (CMS). It was his share of more than $36 million in bonus payments made by CMS for satisfactorily reporting quality information under the 2007 Physician Quality Reporting Initiative (PQRI).

Dermatologists once again find themselves at the mercy of the politicians in Washington, facing significant reductions in Medicare reimbursement for 2008, unless Congress once again comes to the rescue - and President Bush signs whatever legislation is passed.

Dermatologists and other physicians who participate in the Medicare program are facing a tighter financial squeeze as federal officials seek to control costs while giving patients more information about the performance of their healthcare providers.

Funding for the National Institutes of Health and research grants must be improved, she says, if talented young scientists and researchers are to be attracted.

Clearly, health issues will be high on the agenda of the new leadership in Congress. How it shakes out for dermatologists remains to be seen.

Imaging services represented some 14 percent of 2005 spending that is considered in the formula used to calculate Medicare rates, and 27 percent of the total spending increase between 2004 and 2005.

CMS is proposing for ASCs the same payment groups used under the outpatient prospective payment system (OPPS)...CMS also is proposing to modify the criteria for determining whether Medicare will reimburse an ASC for a particular procedure.

Washington - Dermatologists should be aware that the Center for Medicare and Medicaid Services (CMS) is in the process of developing "standards and processes" under the new Medicare drug discount program that takes full effect in January, 2006. The legislation will have a major impact on what drugs are covered and for how much.

While Medicare recipients now have some help in covering the cost of prescription drugs, the new Medicare reform law passed by Congress carries some hidden costs that may result in difficulties in obtaining care for some patients. This applies, in particular, to physicians who administer drugs in their offices.

Congress has been told by its chief investigative agency that increasing medical malpractice awards, indeed, are contributing to skyrocketing premium costs for many physicians, but that fact is not having a widespread impact on patients' access to health care.

The National Institutes of Health, fresh off a five-year doubling of its budget, could benefit from some organizational changes - including giving its directorsignificantly more authority and funding,

There is high drama playing out in Washington this summer, and it pits the insurance industry against trial lawyers, Republicans against Democrats; and dermatologists, like other physicians, are caught in the middle.

While leaders of both political parties say they want to provide Medicare patients with meaningful coverage for prescription drug expenses, major philosophical differences threaten to make that objective extremely difficult to achieve.

Not only did dermatologists not get relief from the Medicare payment cuts imposed in 2002 because of a fee schedule glitch, now more cuts are on the way unless the