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August 31, 2005 |
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Welcome to ACAAI eNews — a bi-weekly aggregated news service
from the American College of Allergy, Asthma & Immunology. To be
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Drugs and Devices |
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Distance Learning |
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Association
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Fellows-in-Training |
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Calendar |
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Archive |
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FIT Archive |
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Seventy-three percent of
readers responding have received a request to substitute a
generic inhaled drug for a brand name medication. |
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The
JCAAI serves a useful role for the allergy
community.
The most valuable service provided by the JCAAI
relates to which of the following issues (see list). |
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Distance Learning |
2005 Board/Recertification Review Course:
DVDs, Audio CDs, MP3s
Link
ACAAI Tape Store
Complete Listing
Link
2004 ACAAI ANNUAL MEETING
Nov. 12-17, Boston
Link
From the 2003 ACAAI ANNUAL MEETING
Nov. 7-12, 2003, New Orleans
• Two Symposia Online
Link
• Plenary Sessions CD-ROM and DVD
Link
Patient-Centered Allergy Practice
Endorsed by ACAAI, Sponsored by Physicians Practice
Link
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Calendar |
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SEPTEMBER
The Long Island Allergy and Asthma Society's
Jointly Sponsored by ACAAI
12th Annual Scientific Conference
Sept. 16-18, Southampton, N.Y.
Contact: Robert Corriel, MD
Tel: 516-365-6077
Email
American
Society for Clinical Pharmacology and Therapeutics (ASCPT)
"Adverse Drug Events and Medication Errors: Impact on Medical
Care in the 21st Century"
Sept. 29-30,
Philadelphia
E-mail
Link
Southeastern Allergy, Asthma
and Immunology Society
2005 Annual Meeting
Sept. 29 – Oct. 1, Sea Island, GA
Contact: Jack Eades, MD
Tel: 912-303-9355
Email
OCTOBER
New Trends & Recent Applications
in Allergy, Immunology and Infectious Diseases
Co-sponsored by ACAAI
Oct. 6-8,
Taormina, Sicily
E-mail:jbella007@aol.com
or IRConsult@aol.com
Link
Update in
Allergy Immunology
Nassau
University Medical Center
Oct. 27,
East Meadow, NY
Tel: Dr. Marianne Frieri at 516-572-3214
Email
Update on Immunotherapy
and Immunomodulators
New York Allergy and Asthma Society
Jointly Sponsored by ACAAI
Oct. 28, New York, N.Y.
Contact: Dr. Beth Eve Corn
Tel: 212-241-0764
E-mail
ONGOING
World Allergy Organization Society Meetings
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Top
Stories |
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RNA gene offers clues to immune dysfunction
Researchers at the University of Pennsylvania Medical
School's division of infectious diseases have better defined the
role of genetic material called ribonucleic acid (RNA) in the
operation of the body's immune system, according to a study in
Immunity. Scientists demonstrated that RNA from bacteria
stimulated immune cells to orchestrate the destruction of
invading pathogens. Other findings: RNA from human cells is
recognized by the immune system as coming from the same body.
Therefore, RNA itself shouldn't trigger an immune attack. 
Asthma triggers at work affect asthma
severity
Exposure at work to substances that trigger asthma can
affect the severity of the disease, says a study in the
American Journal of Respiratory and Critical Care Medicine.
French researchers analyzed data from 148 adults with asthma and
from 228 control subjects, examining the impact of occupational
exposures on asthma severity. Exposure to any occupational
asthma-triggering substances was tied to an increased risk
(3.7-fold to 7.5-fold) of severe asthma. In contrast, they saw
no significant associations between non-asthma-causing irritant
exposure and asthma severity.
U.S. NIH issues revised ethics
regulations
The U.S. National Institutes of Health recently issued
revised ethics regulations, including new rules on investments
and consulting in the health industry. One such rule requires
certain top-level employees and their family members to sell
investments that might be perceived as affecting their judgment.
Another rule prohibits employees from consulting for
pharmaceutical, biotechnology or medical device manufacturing
companies, health care providers or insurers, and research
institutions that receive NIH grants. In addition, certain
employees must disclose their investments via reports.
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 A
word from Dr. Myron Zitt, president
As I near the end of my term as president of the ACAAI, I
would like to take this opportunity to acknowledge and
thank the Joint Council of Allergy Asthma & Immunology (JCAAI)
for all the wonderful work it performs for our specialty.
Established in 1975, the JCAAI is the
socioeconomic/political advocate of the College and the
Academy. Its mission is to act on our behalf to provide a
unified voice in medical socioeconomics, which will enable
our patients to receive the highest quality of allergy
care. (Remember, “Nobody does it better than the
allergist.”)
The JCAAI represents our specialty in federal and state
regulatory and governmental agencies, the Congress, in
areas of reimbursement and in other areas where
appropriate. It also provides a mechanism, through a
highly informative Web site, weekly e-newsletters to its
membership and direct correspondence with our national
societies, to keep us abreast of critical issues that
affect our practices, including:
Medicare Fee Schedule: JCAAI is closely monitoring
Medicare Fee Schedule discussions. The formula for
arriving at reimbursement rates is flawed, and if Congress
does not fix it, physicians face a 5-percent-per-year cut
in reimbursement through 2012. On behalf of the
allergist/immunologist, JCAAI has joined the specialty
coalition that is opposing these reductions and advocating
a change in the flawed formula.
Pay-for-Performance (P4P): In an effort to offset
the declining reimbursement fee schedule, a P4P option is
being established whereby physicians are to be paid based
on the quality of care they provide rather than at a set
rate. It is unclear how “good performance” would be
measured and equally unclear how it could be rewarded
without adversely affecting the Medicare program or
reimbursement for physicians not receiving bonus monies.
JCAAI is currently coordinating a joint committee with the
ACAAI and the AAAAI to establish appropriate
allergy/immunology quality measures for the P4P option.
Coding Issues: Every five years, a series of codes
are reviewed by CMS/AMA. JCAAI has randomly surveyed
practicing allergists regarding their expenses on skin
testing and administration codes that, generally, do not
require physician “work” (Zero Work Pool Codes). Based on
the replies, various simulations were developed predicting
what the outcomes would be if we requested CMS to add work
value to these codes. JCAAI has submitted this data to CMS
and requested that the allergy codes with no work values
be assigned Relative Value Units (RVUs) to help mitigate
the expected effect of the elimination of the Zero Work
Pool.
Recently the JCAAI submitted an application on behalf of
AAAAI, ACAAI and JCAAI to the AMA to establish a CPT code
for Exhaled Nitric Oxide. It continues to seek more
advantageous coding for the administration of
Omalizumab.
Many allergists are struggling with the reduced rates of
reimbursement for IVIG. While JCAAI has determined
that RVUs for this service cannot be increased, it is
prepared to organize a Buying Cooperative to assist these
physicians if the Immune Deficiency Foundation (IDF)
does not do so. With its larger membership, IDF could
purchase increased quantities of material, resulting in
greater financial savings for physicians.
Advocacy regarding coding and reimbursements. JCAAI
provides information and individualized responses to
physicians regarding coding and reimbursement issues. This
past year, Empire BC/BS of New York declared that it would
not compensate physicians for immunotherapy (IT) beyond
three years, claiming this practice was “inappropriate.”
JCAAI was able to provide a legal opinion indicating that
practice parameters should not be used to limit or deny
coverage. Along with clarification of the practice
parameters by members of the Joint Task Force on
Immunotherapy and a strong letter from the president of
the Medical Society of the State of New York, Empire
agreed to accept the JCAAI forms for maintaining IT beyond
three years and acknowledged the expertise of our
specialty in making decisions regarding allergy care.
Reimbursement challenges can be anticipated, and in fact,
have occurred in other states.
Formulary Guidelines: The United States
Pharmacopeia (USP) formulary is being established to
accommodate the addition of the Medicare Part D
pharmaceutical coverage that goes into effect Jan 1, 2006.
JCAAI, working with the College and the Academy, has
submitted a list of drugs used and deemed essential by our
specialty to the USP Formulary Guideline Group to help
ensure their formularies would cover all reasonable and
necessary drugs for the treatment of asthma and other
allergic diseases. Many, but, unfortunately, not all of
the drugs we recommended were included in the formulary.
As this remains an issue of concern, JCAAI has submitted a
follow-up comment letter.
HIPAA Guidelines: JCAAI has developed a program for
educating members on the new HIPAA Security Rules that
became effective April 21, 2005. This educational program
is available at no charge to members of the JCAAI via its
Web site.
CFC-containing Metered Dose Inhalers (MDIs): JCAAI,
joined by the College and Academy, sent a letter to the
FDA supporting the removal of ozone depleting
CFC-containing MDIs. The FDA has announced that as of
December 31, 2008, CFC Albuterol MDIs will be taken off
the market.
Clincal Research: The NIH continues to develop
guidelines for restricting clinical research investigators
based upon conflicts of interest. JCAAI monitors and
distributes all information to the JCAAI Clinical Research
Committee.
So much more… The JCAAI routinely monitors
legislation and continuously updates its members regarding
Fair Access to Clinical Trials; Medical Malpractice and
Liability; Patient Safety and Quality Improvement; Genetic
Non-Discrimination; Sen. Hillary Clinton’s Family Asthma
Act; Drug Re-importation; Public Health Emergency
Preparedness; and FDA issues pertaining to drug approval
and safety.
The Board of the JCAAI will convene Sept. 21-23, 2005, in
Washington, not only to discuss policy, but also to meet
with our state legislators in an effort to influence them
on issues that impact on our practices and the well-being
of our patients.
My theme for this year has been “nobody does it better
than the allergist.” For our patients to retain access
to our expertise and to the therapies that we recommend
for asthma and other allergic diseases, we must maintain a
strong legislative and socioeconomic presence. It is
alarming to me that less than half of the allergists
practicing in this country are members of the JCAAI. I
would urge those of you who are not already members of the
JCAAI to support the preservation of our specialty by
joining now. The membership fee is a very reasonable $150
per year, and a physician’s staff now can join as
Associate Members at reduced rates and have access to all
member benefits.
Please check out the new
JCAAI Web
site for further information.
I would like to thank Dr. Stanley Fineman, JCAAI
President, for the material used to prepare this
e-newsletter.
Dr. Myron Zitt
President, American College of Allergy Asthma & Immunology |
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Drugs
and Devices |
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FDA OKs montelukast for
perennial allergic rhinitis
Merck & Co. Inc. recently announced that the U.S. FDA has
approved montelukast (Singulair) for use against year-round
allergic rhinitis in adults and children six months and older,
further expanding the drug's potential use.
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Association
News |
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 Attend
the Jay Leno benefit performance,
help support research, education, children’s asthma camps
Tickets are going fast for the ACAAI 14th Annual Fundraising
Dinner with the star and host of NBC’s top-rated late night
talk show, The Tonight Show with Jay Leno. The benefit
performance will be held Sunday, Nov. 6, 2005 at the ACAAI
Annual Meeting in Anaheim.
The fundraising program includes a reception, dinner and
performance. Net proceeds from the event will be donated to
the ACAAI Foundation to support
The
Consortium on Children's Asthma Camps; Scholars Return
Programs; and Young Faculty Support Awards.
Purchase your tickets online when you
register or send with your ACAAI Fundraising Dinner
order form.
College members generously respond to needs of their
specialty
Join 41 other members who have reached their Foundation
“Committee of 500” goal by contributing in a variety of ways,
including personal donations, participation in the
Tithe-a-Talk program, or even through a contribution of
stock.
The Tithe-a-Talk
Contribution Form makes it easy to donate honoraria
from a speaking engagement without having it added to taxable
income. Simply complete the downloadable form and (1) present
it to the association/company that is sponsoring your talk,
and (2) send a copy to ACAAI for acknowledgment of your
contribution.
The following members of the Committee of 500 who have
made their pledge of contributing $5,000 or more to the
Foundation will be acknowledged at the ACAAI Annual Meeting in
Anaheim with a special ribbon and listings in the Convention
Program Guide and the Foundation Honor Roll Board:
Emil J. Bardana, Jr.
Robert J. Becker
Joseph A. Bellanti
William E. Berger
Michael S. Blaiss
Larry Borish
David A. Brown
Jean A. Chapman
Bradley E. Chipps
James R. Claflin
Lawrence M. DuBuske
David B. Engler
John E. Erffmeyer
Jafar Farnam |
Stanley M. Fineman
Linda B. Ford
Richard G. Gower
Bobby Z. Joseph
Martin J. Kaplan
Roger M. Katz
Kenneth T. Kim
Jerald W. Koepke
Bobby Q. Lanier
William R. Lumry
Lyndon F. Mansfield
Lawrence S. Mihalas
Don Q. Mitchell
John E. Moffitt |
Robert A. Nathan
Harold S. Nelson
Edward J. O’Connell
Hobert L. Pence
Bruce M. Prenner
Russell R. Roby
Diane E. Schuller
Nathan Segall
John C. Selner
Dennis L. Spangler
Dale B. Sparks
Richard W. Weber
Betty B. Wray
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Allergy Practice Tip: Index It
Advice from The Patient-Centered Allergy Practice
There are many processes in allergy practices that take far
more steps than needed. Look at some of your workflow bugaboos
– sending referral letters, scheduling appointments – and
chart out each step required, one step to one index card. When
you are done, see if you can get rid of some steps and still
get the job done. For more advice, visit
www.PatientCenteredAllergyPractice.com.
These tips are drawn The Patient-Centered Allergy Practice,
a CME Series in Practice Management, supported through an
educational grant from sanofi-aventis Group and
endorsed by the American College of Allergy, Asthma &
Immunology. |
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Fellows-in-Training |
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Welcome to the Board Review Corner prepared by Dr. Thao N.
Tran, Senior Representative of ACAAI’s fellows-in-training (FITs)
to the Board of Regents. The Board Review Corner is your chance
to test your Board preparedness.
To refer to a previous Board Review Corner, click the “Archive”
link in the left column.
Immunology Review Corner: Chapter 54 of the 6th
edition of Middleton’s Allergy Principles and Practice,
edited by N. Franklin Adkinson, et al. Review questions were
written by fellows-in-training Dr. Thao N. Tran and Dr. Todd
Levin.
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