National Legislation and Legislation in Other States

Congress

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ADA 2018 Lobbying Highlights

In Congress

Congress Passes $1.4 trillion Spending Package

Congress voted on H.R. 1865, to approve $1.4 trillion to keep the government running through the remainder of fiscal year 2020. The bills include funding for many of the Association's key advocacy issues affecting oral and overall health.

Medicaid funding for the territories. Extends funding to the U.S. territories for FY2020 and FY2021; includes important program integrity improvements for Puerto Rico’s Medicaid program. This funding will be available at a Federal Match rate of 76% for Puerto Rico and 83% for the other territories

Extension of demonstration projects to address health professions workforce needs. Extends funding for the HPOG demonstration through May 22, 2020. In fiscal year 2020, local HPOG grantees will enter the fifth year of demonstration grants which require them to use a career pathways approach to help disadvantaged workers enter health professions in need of workers. In addition to the grants, HPOG funding supports rigorous evaluation and technical assistance to grantees

Extension for community health centers, the national health service corps, and teaching health centers that operate GME programs. Extends the Community Health Centers Fund and National Health Service Corps Fund through May 22, 2020. Additionally, it continues current funding for the Teaching Health Center Graduate Medical Education through May 22, 2020. These programs improve our medical workforce by supporting the training of health providers in underserved areas.

Minimum age of sale of tobacco products. Updates the Federal Food, Drug, and Cosmetic Act to increase the minimum age of sale of tobacco products from 18 to 21 years of age.

Sale of tobacco products to individuals under the age of 21. As a condition for receiving block grant funding under Section 1921 of the Public Health Service Act, continues a requirement that states conduct inspections to ensure retailers do not sell tobacco products to individuals under a certain age, updates that age to 21 years of age, and requires reporting on relevant activities. Provides flexibility for states found to be in non-compliance, including adding an option for a negotiated corrective action plan. Authorizes grants to states to support transition to the updated requirements.

Repeal of the 2.3% excise tax on medical devices.

Repeal of the 40% excise tax on high cost employer-sponsored health coverage.


[Contact: Jennifer Fisher 202-789-5160 or fisherj@ada.org]

Permanent Repeal of the Medical Device Tax Passes Congress

Also included as part of the spending bill is the permanent repeal of the 2.3% medical device tax created by the Affordable Care Act. The ADA along with Academy of General Dentistry (AGD) and other stakeholders, both in and outside of the dental community, have long advocated for this permanent repeal. The bill also included a repeal of the so-called Cadillac tax and a fee on health insurance plans. It repeals the 40% excise tax on high cost employer-sponsored health coverage. Repeal of the medical device tax will ensure that the cost of a 2.3% tax for medical device manufacturers will not be passed onto providers and their patients. President Trump signed into law on December 20, 2019.

[Contact: Megan Mortimer 202-898-2402 or mortimerm@ada.org]

OTC Monograph Passes the Senate

On December 10, S. 2740, the Over-the-Counter Monograph Safety, Innovation, and Reform Act of 2019, passed the Senate by a vote of 91-2. This bill would update the federal government’s outdated system for considering whether new drugs with ingredients that are generally accepted as safe and effective may be sold over-the-counter. This bill would help modernize the Food and Drug Administration’s monograph drug approval process. The bill now goes to the House for consideration, where the ADA has asked leadership to bring it to the floor for a vote.

[Contact: Natalie Hales 202-898-2404 or halesn@ada.org]

H.R. 3 Passes the House

The House of Representatives voted on H.R. 3, “Lower Drug Costs Now Act of 2019”, Speaker Nancy Pelosi's (D-CA) drug pricing bill, which uses the savings from prescription drug pricing reforms to add dental, vision, and hearing benefits to Medicare. The vote passed mostly on party lines by 230 – 192.

The ADA expressed concerns to the House that the proposal may not adequately address the needs of seniors in the most appropriate and equitable way. Senate leadership does not currently plan to bring the bill for a vote. The president has already issued a veto threat against this bill.

[Contact: Mike Graham 202-789-5167 or grahamm@ada.org]

Other States

Enacted this year in Mississippi, HB 752 declares claim denials may only be performed by a licensed dentist, with appropriate specialty as needed, and prohibits dental consultants from being employees of the dental plan.  Denials based on medical necessity must include contact and licensure information of the dentist making the adverse determination.

The new law also prohibits dental carriers from denying any claim for services included in a prior authorization unless a defined set of circumstances negate the authorization.  Carriers must issue prior authorizations within thirty days of the date a request is submitted by a dentist.

It prohibits plans from recouping a claim payment solely due to a patient's loss of coverage or ineligibility if the insurer erroneously confirms coverage and eligibility, but had sufficient information that the patient was no longer covered or was ineligible for coverage.

[Contact: Paul O'Connor 312-440-2873 or oconnorp@ada.org]




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