March 2019 Volume LIV Number 2

 
 
 
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Legislative and Regulatory Update

March 2014 Volume L Number 2

 Unless otherwise noted, for further information on any of these issues please contact Chief Operating Officer and General Counsel C. Scott Litch at (312) 337-2169 or slitch@aapd.org.
 

FEDERAL NEWS

Title VII Funding

 

FINAL FY 2014 APPROPRIATIONS INCLUDES $8 MILLION FOR PEDIATRIC DENTISTRY TRAINING, NO FUNDS PROVIDED FOR ALTERNATIVE DENTAL PROVIDERS The House and Senate Appropriations Committee leadership on Jan. 13, 2014, released the Consolidated Appropriations Act of 2014, an omnibus agreement providing funding for all 12 spending bills, including Labor-HHS-Education. The AAPD's top appropriations priority, funding for Title VII pediatric dentistry, received our requested amount of $8 million. The AAPD also worked closely with the ADA to obtain language that prohibits federal funding for dental therapist or other alternative provider demonstration projects.

 

Background: The authority to fund pediatric dentistry residency training under Title VII was first enacted under the Health Professions Education Partnerships Act of 1998. This expanded the existing general dentistry training authority, providing "start up" funds to either increase pediatric dentistry positions at existing programs or initiate new programs. In the first decade-plus of funding, almost $60 million has supported over 60 pediatric dentistry programs, including 10 new programs. Under the Affordable Care Act (ACA), Title VII authority was expanded to create a primary care dental funding cluster under Section 748 of the Public Health Service Act. Authority was broadened to allow use of funds for faculty development, predoctoral training, and faculty loan repayment. The latter initiative had long been advocated by the AAPD, on account of the significant difficulties in recruiting qualified individuals to fill faculty positions.

 

FY 2014 Final Appropriations: The bill provides $245.4 million for health professions training (Title VII), an 11.3 percent increase over FY 2013 post-sequestration funding levels, and $228.8 million for Title VIII (nursing), a 5.2 percent increase over FY 2013 post-sequestration funding levels. Most programs received a slight increase over the FY 2013 post-sequestration funding levels, while the geriatrics, oral health, mental and behavioral health, public health and prevention, and workforce information line items received larger increases. The bill provides a 4.3% increase for the oral health primary care training cluster, with the following report language:

 

HEALTH WORKFORCE Oral Health Training.—The agreement includes not less than $8,000,000 for General Dentistry programs and not less than $8,000,000 for Pediatric Dentistry programs. The agreement includes bill language prohibiting health workforce funds to be used for section 340G-1, the Alternative Dental Health Care Providers Demonstration program. 
 

The bill can be found at: http://docs.house.gov/billsthisweek/20140113/CPRT-113-HPRT-RU00-h3547hamdt2samdt_xml.pdf. The explanatory statement, which includes the specific funding charts, can be found at: http://docs.house.gov/ billsthisweek/20140113/113-HR3547-JSOM-G-I.pdf. The final bill was signed by President Obama on Jan. 17, 2014.

 

The AAPD thanks all of those advocates who attended the Public Policy Advocacy Conference in Washington, D.C., in March 2013, which included advocacy for this program. The AAPD especially thanks Congressional Liaison Heber Simmons Jr. and Mike Gilliland and Kate McAuliffe at Hogan Lovells in Washington, D.C., for all of their efforts throughout the long budgetary process.

 

 Affordable Care Act (ACA) Regulatory Issues

 

AAPD AND ADA COMMENT ON FEDERAL REGULATIONS FOR PEDIATRIC DENTAL BENEFITS IN 2015 On Dec. 18, 2013, the AAPD and the ADA filed joint comments with CMS concerning their proposed rule on benefit and payment parameters for 2015 as they apply to stand-alone dental plan (SADP) coverage under the Affordable Care Act (ACA). The proposal would reduce the annual limit on cost-sharing for stand-alone dental plans to $300 for one child and $400 for two or more children, in addition to eliminating the actuarial value (AV) requirements. The AAPD and ADA support affordable dental insurance, but raised concerns about the unintended consequences of these proposals. The proposals could drive up the cost of premiums for SADPs and shift the market away from typical dental benefits that provide important preventive and diagnostic services with limited or no cost sharing. For a copy of the letter see: http://www.aapd. org/aapd_and_ada_comment_on_federal_regulations_for_pediatric_dental_benefits_in_2015/.

 

AAPD AND ADA COMMENT ON FEDERAL BASIC HEALTH PROGRAM PROPOSED REGULATIONS On Nov. 25, 2013, the AAPD and the ADA filed comments with CMS concerning their proposed rule on Basic Health Programs (BHPs). Such programs are an option for states beginning on Jan. 1, 2015, to cover individuals who do not qualify for Medicaid but whose income does not exceed 200 percent of the federal poverty level. BHPs are required to offer the essential health benefits package under the ACA, including a pediatric dental benefit. The ADA and AAPD urged that BHPs address challenges that currently exist in Medicaid and CHIP dental programs: network adequacy and low reimbursement levels. Recommendations were made concerning appropriate state contracting, quality measures, and cost sharing. For a copy of the letter see: http://aapd-oldsite.ae-admin.com/assets/1/7/BHP_comments_from_ AAPD_and_ADA-November25.pdf.

AAPD 2014 LEGISLATIVE AND REGULATORY PRIORITIES The AAPD's 2014 Legislative and Regulatory Priorities as developed by the AAPD Council on Government Affairs and approved by the AAPD's board of trustees are available at http://aapd-oldsite.ae-admin.com/assets/1/7/2014LegPriorities.pdf.

 

Top priority issues continue to be Title VII funding, ACA implementation (numerous issues related to the essential pediatric oral health benefit), and Medicaid dental reform (including audit issues).

 

STATE NEWS

AAPD Supports Non-Covered Services Legislation in Florida and Ohio

In November 2013, the AAPD sent letters to legislators in Florida and Ohio in support of pending noncovered services legislation. This legislation would prevent insurers from setting prices for services their plans do not even cover. The AAPD believes such insurance practices hurt access to care and interfere with the patient-doctor relationship. Laws preventing such practices have already been approved in 33 states. The pending non-covered services bills are strongly supported by the Florida Dental Association and the Ohio Dental Association, as well as the respective pediatric dental associations in each state. This effort was coordinated with our Public Policy Advocates in each state (Dr. Eli White in Florida and Dr. Homa Amini in Ohio). For a copy of the Florida letter see: http://aapd-oldsite.ae-admin.com/assets/1/7/2013-11-13-Non-Covered_Services_Letter_for_Florida_Legislatures.pdf. For a copy of the Ohio letter see: http://www. aapd.org/assets/1/7/2013-11-06-Letter_of_Support_for_ODA-Ohio_House_Bill_159.pdf.