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Breaking news (5/11/12):  The FDA announces that it will delay enforcing their sunscreen label rules from July to mid-December of 2012 for larger companies. And smaller manufacturers will get an extra year to comply with the rules.

Starting this summer, sunscreen makers will be following a new set of labeling rules created by the Food and Drug Administration. The FDA’s goal is to standardize “broad-spectrum” and “water resistant” claims.

New Labeling Highlights

• Sunscreens must meet FDA testing standards for both UV-B (SPF of 15 or higher) and UV-A to be called “broad-spectrum protection.”
• Sunscreens providing UV-A protection and UV-B protection below an SPF of 15 can still be labeled broad spectrum but must warn that the product has not been shown to prevent skin cancer or premature skin aging.
• The misleading terms “sunblock,” “waterproof” and “sweatproof” can no longer be used.
• Labels can’t say sunscreen is over 50 SPF, since there’s no evidence that sunscreens claiming >50 SPF offer more sun protection.
• In order to use the term “water resistant,” sunscreens must pass a 40 or 80 minute water immersion test to prove that they maintain their SPF rating.
• All sunscreen labels must have an easy-to-find fact box listing product information and warnings.

What’s the Big Deal?

The Sun Protection Rating (SPF) has up until now only told you how well a sunscreen protects you from UV-B, the light responsible for sunburns. However, both types of ultraviolet light, UV-A and UV-B, cause photodamage to skin that can lead to skin cancer. With the new “broad-spectrum protection” rules, you will know when you’re protected against both. You will also know how long you can stay in the water before reapplying sunscreen.

What happened with Premera Blue Cross?

You may receive a letter from your insurance carrier, Premera Blue Cross, notifying you that their contract with the Center for Excellence in Dermatology terminates on June 16, 2012.  Please be aware you can continue to receive medical services here until that date.

This action was initiated by Premera and was “without cause.”  Click here for a copy of the termination letter we received from Premera.  Based on feedback from our patients, Premera’s consumer representatives have told patients several different explanations for the termination: That the Center for Excellence for Dermatology canceled the contract, that the Center for Excellence in Dermatology was out of compliance with the contract, and that if the Center for Excellence in Dermatology would only sign the contract there would be no problem. These statements are not true.  Premera has not provided the Center for Excellence in Dermatology any written explanation for their decision to terminate our contract despite written inquires.

Why would Premera do this?

Seven months ago the Center for Excellence in Dermatology settled a three-year audit dispute with Premera. We believe the terms were not favorable for Premera. At the time of settlement, the Center for Excellence in Dermatology was concerned there would be a retaliatory action by Premera. It appears to us that Premera has retaliated.

What does this mean to me?

There are several consequences that follow Premera’s action that will affect you as a patient:

• Increased wait times to see specialists in dermatology. Based on the current waiting list at the Center for Excellence in Dermatology and the waiting lists at the two other local dermatology practices, the wait time to see an in-network specialist in dermatology will increase from 2 weeks to 17 weeks for Premera Blue Cross patients.
• Increased out-of-pocket costs for patients who want to continue their care with the provider of their choosing who will now be out-of-network.
• Increased drive time to access services in Spokane that are currently available in the Tri-Cities but not accessible by a preferred provider. Additional unreimbursed costs include gas, food and hotel accommodations for trips to Spokane for treatment or services from in-network providers.
• Lack of access to unique services that are not offered elsewhere in the Tri-Cities including Moh’s surgery for skin cancers, extended patch testing, intravenous infusion therapy for psoriasis and mole mapping for high risk melanoma patients.

The Center for Excellence in Dermatology currently has 17,398 patients listed in its database as having Premera insurance. Many of these patients are on medications that require monitoring, have skin conditions that need regular treatments, or have a history of skin cancers that need follow up. These patients will be left without access to the specialty care they need.  Premera seems willing to put the physical and financial health of these patients at risk to retaliate for the outcome of a business disagreement that did not go their way.

A history of questionable business practices

Premera’s business practices have been challenged in the past. A class action lawsuit, Love et al. v. Blue Cross Blue Shield Association, et al. , was filed in 2003 before U.S. District Judge Federico Moreno in federal court for the Southern District of Florida in Miami. The complaint identified numerous Blue Cross and Blue Shield plans, including Premera Blue Cross of Washington, as defendants in an alleged scheme to defraud doctors in violation of the federal Racketeer Influenced and Corrupt Organizations (RICO) Act. Click here to see a press release from this settlement announcement. You can read more at:

http://www.hmosettlements.com/pages/bluecross.html

What can you do?

You and your employer pay Premera a great deal of money to receive health insurance and those costs go up substantially every year. These increases in premiums occur at the same time that Premera, which is a nonprofit company, builds a $956.6 million cash “reserves” fund. Premera has a moral and ethical obligation to act in the best interests of the lives they are trusted to insure. By putting their business concerns and profits before patient care considerations they are not living up to this fundamental obligation. See the Seattle Times article from 2/8/12:

3 big health insurers stockpile $2.4 billion as rates keep rising

Write or Call your company’s health benefits manager

Let the benefits manager who buys the insurance policy for your company know that you are not happy. Tell them that the increase in out-of-pocket costs and decreased access to care are not acceptable. There are other alternatives to Premera in the market.

Write the Washington State Insurance Commissioner

File a consumer complaint with the Insurance Commissioner for Washington State. You can go online to:

http://www.insurance.wa.gov/consumers/complaints.shtml

or write to:

Washington State Office of the Insurance Commissioner
PO BOX 40256
Olympia, WA 98504-0256

or call: 1-800-562-6900 or (360) 725-7080

or fax: (360) 586-2018

File a complaint with Premera

File a written complaint with Premera and let them know how you feel. Let them know about the issues of: Your loss of access to specialty care, the increase in your out-of-pocket costs, the loss of continuity in your patient care and your loss of access to specialty services like Moh’s surgery in the Tri-Cities. Be sure to include your name, mailing address, Premera ID number and date of birth on the correspondence. (And, if they send you a reply, please send us a copy.) Their address is:

Premera Blue Cross
Complaint Department
PO BOX 91056
Seattle, WA 98111-9159

Just say no

Your access to health care is in jeopardy. Large insurance companies will continue to make policy decisions that put patients at risk unless you stand up and say, “No.” Make sure your voice is heard.

We care about your health

I speak for all the staff and employees at the Center for Excellence in Dermatology when I say we want to be there for you when you need us as we continue our 22 years of service in the Tri-Cities. We appreciate the trust and confidence that you have shown by letting us participate in your medical care, and look forward to providing you with excellence in dermatology for many years to come.

If you have questions, comments or want to talk further please call Sara Reyna, Lacey or Erin here at the Center for Excellence in Dermatology, or visit this page on our website for updates and news about the termination issue.

Sincerely,

Robert B. Hopp, MD

P.S. Here are a couple of other ideas to make your voice heard on this issue:

• Complain about it on your Facebook page or our Facebook page. Tweet about it on Twitter, and make sure we see your Twitter message by including @HoppDermatology in your message. Complain on any other blog or social media you have access too. The more people you tell the more likely it’ll have an impact.
• Print out the information in the letter we’re sending our patients about this issue and pass it along.
• Leave a comment below to let us and everyone who visits our website know how you feel.

What is PDT?

PDT treatment involves applying a topical solution to the skin making it very sensitive to light, then exposing it to a particular wavelength of light. This targets and destroys the damaged cells, leaving healthy cells intact.

So why do we do so many PDTs?

In our office we primarily use PDTs to treat patients who have actinic keratosis. AK is so common that they’re one of the most frequent reasons people see dermatologists. AK shows up as dry, scaly, rough-textured patches that usually occur after years of unprotected sun exposure. If left untreated, they have the potential to develop into skin cancer.

The advantages of PDTs over other treatments for AK are:

• Low downtime
• No prescription to fill
• No daily medication to remember
• Excellent cosmetic response
• No scarring

For more information, go to: www.drhopp.net/pdt

What is Rosacea?

Rosacea is a common skin disorder that usually affects the face, and sometimes affects the scalp, neck, ears, chest, back and eyes. The cause is unknown and there is no cure, however treatments are available that will help control its symptoms, which include:

• Tendency to flush or blush easily
• Persistent redness of the cheeks, nose, chin or forehead that resembles a sunburn that doesn’t go away.
• Small visible blood vessels on the face.
• Bumps or pimples on the face.
• Watery or irritated eyes.
• Increasingly dry facial skin, burning, stinging or itching.
• Small, knobby bumps on the nose; swollen looking nose and cheeks.

Since rosacea varies so much between patients, a customized treatment plan needs to be created by your dermatologist.

Treating Rosacea

Some of the possible treatments are listed below:

• Oral antibiotics, often in low doses, to reduce inflammation
• Topical medications
• Laser treatments with Pulsed Dye Laser (PDL), DioLiteXP and Intense Pulsed Light™ (IPL) to reduce redness and get rid of visible blood vessels
• Chemical peels and extractions
• Gentle skin care routine, sunscreen
• Avoiding rosacea flare-up triggers

For more information go to: www.drhopp.net/rosacea

Buy a 3-treatment Rosacea laser package between April 1 – May 31, 2012, and get an additional 15%
off our already discounted package price.

Sometimes there’s just not enough hours in the day to get things done. To help our patients who have work or school schedules that don’t let them come in during our regular hours, we are staying open later. Some of our medical providers will be available Tuesdays through Thursdays until 7 p.m. Also, our Skin Treatment Center will be available for cosmetic appointments until 7 p.m. on Tuesdays and Thursdays by appointment only.

Call 509-735-1100 to schedule your after-work medical appointment now.

Call 509-735-1100, ext. 114 to schedule your after-work cosmetic treatment now.

Dermatologist Zoe D. Draelos, MD, spoke to these concerns at the 69th Annual Meeting of the American Academy of Dermatology recently, explaining how you can have lustrous healthy hair. Her advice boils down to less is more: Less heat when styling your hair, and fewer chemical treatments will result in less damage. For the full scoop on tips for beautiful hair, check out the story at: http://www.medicalnewstoday.com/articles/215762.php