Advocacy

Recent News

May 4, 2012

CMS and States Need Better Oversight, ADA Tells Senate Finance Committee Chairman

The ADA today told Sen. Charles Grassley (R-Iowa), a senior member of the Senate Finance Committee, that the Centers for Medicare and Medicaid Services (CMS) and the states must conduct better oversight of Medicaid to ensure that the program spends money wisely and provides access to services required by federal law. Sen. Grassley is concerned over how Medicaid programs in the states are monitored.

In a letter to the senator, ADA President William Calnon and Executive Director Kathleen O’Loughlin  stressed the importance of a uniform, transparent process to determine the actuarial soundness of rates, which state programs can use to review and evaluate new or existing managed care contracts.

May 1, 2012

Third Barriers Paper Examines Role of Financing

The American Dental Association today released the third in a series of papers that examine the challenges and solutions to bringing good oral health to millions of Americans who, for multiple reasons, lack access to regular dental care.  "Breaking Down Barriers to Oral Health for All Americans: The Role of Finance" explores how the availability of financing affects people’s oral health, various methods of paying for care, and recommendations for improving the system.

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April 27, 2012

ERISA Bill Would Address Consumer Benefits Issues

Rep. Gosar yesterday introduced a consumer-friendly bill to amend the Employee Retirement Income Security Act (ERISA), which, among other things, would alter how insurance law handles assignment of benefits and coordination of benefits in dental plans. This would help ensure that patients are treated fairly and receive the full value of their coverage.

Legislation Would Address Drug Shortage Problem

The Senate this week approved ADA-supported legislation that would require manufacturers to provide advance notification before discontinuing certain drugs, or if the manufacture will be interrupted. It would also authorize the FDA to expedite the review of new drug applications and document the number of drug shortages that occur each calendar year and the known factors contributing to those shortages. 

The language is part of the Prescription Drug User Fee Act (PDUFA) reauthorization act, which passed the Senate by voice vote. The House Energy and Commerce Committee plans to take up the legislation the week of May 8.

House Hearing Examines Alleged Medicaid Dental Fraud in Texas

The House Committee on Oversight and Government Reform heard testimony on Medicaid fraud, including allegations that the Texas Medicaid program was improperly billed for orthodonture.  At the hearing, billed as, "Is Government Adequately Protecting Taxpayers from Medicaid Fraud?,” the committee heard from Dr. Christine Ellis, an orthodontist with the University of Texas Southwestern Medical Center, who testified about her work for the Texas Office of the Inspector General in determining the medical necessity of Medicaid orthodontic services performed in the state.

Committee members also heard from Cindy Mann, director of the federal government’s Center for Medicaid and CHIP services. The committee expressed concern that Texas’s Medicaid orthodontic costs are greater than all other states combined and demanded to know how state officials could ignore that “red flag.” Ms. Mann explained that CMS expected Texas costs to be higher due to program changes and that the way the state’s system was set up, it did not differentiate between orthodontic and other dental services. She noted, however, that the agency is developing new mechanisms that will allow it to better detect fraud. Every member of the committee stressed the need for the federal government to recover Medicaid money paid out inappropriately.

While this hearing did not involve organized dentistry in any way, ADA staff monitored the proceedings and will continue to track the issue closely. The ADA also prepared a brief statement on the hearing, which is available here.

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March 29, 2012

Bill Would Give Small Businesses a One-Year 20-Percent Tax Deduction

The House Ways and Means Committee yesterday approved legislation (H.R. 9) that would provide businesses with fewer than 500 employees—including dental practices—a one-year tax deduction equal to 20 percent of their profits. The full House is expected to vote on the bill in the next two weeks. The ADA supports the measure.

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ADA's State Public Affairs Program Bolsters State Advocacy Efforts

To help the 52 state-level dental societies in their advocacy efforts, the ADA in 2006 created the State Public Affairs (SPA) program, which has quickly become the cornerstone of the association's issues management program with the states. The SPA program's core philosophy recognizes that while states' goals may vary, the lessons learned underneath one capitol dome can be used effectively in others. Providing strategic advice to deal with legislative and regulatory issues in the states and supplementing the resources available to enrolled constituent societies is the strength of the SPA program. This year SPA is operating with a $3.5 million budget.

Working closely with volunteer leaders and state dental society staff, SPA provides grants to assist states with lobbying, coalition building, opinion research, earned and paid (advertising) media and retaining local public affairs firms to assist with this work. The consulting firms work at the frontlines in the legislatures, monitoring developments, and delivering dentistry's messages to key audiences of those who make and influence policy decisions. Issues that the SPA program has assisted states with over the years include access, fluoridation, workforce, amalgam and Medicaid reform.

Participating states (there are 20 this year) receive more than funding through SPA. The ADA also devotes considerable staff time to overseeing the work of state consultants, and providing strategic counsel and technical assistance the program. In addition, the association has retained the services of a Washington, D.C., consulting firm to help implement strategies in the states. The SPA program has evolved over the years, due in part to shared learning among participating states. Participating states often have found that the best defense against bad policies proposals is to offer alternative solutions .
The activities of the SPA program are overseen by a committee of volunteer dentists representing the ADA Councils on Government Affairs and Communications and the Board of Trustees.

The SPA program brings ADA resources back to the state and local levels, where they can help dental societies advocate and deliver their messages more effectively.

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March 21, 2012

Legislation Repealing Insurance Industry’s Antitrust Exemption Gets Boost in House

The U.S. House Rules Committee yesterday afternoon approved an amendment that would repeal aspects of the McCarran-Ferguson Act’s 67-year-old antitrust exemption granted to insurance companies. The Committee’s action will allow dentist-lawmaker Rep. Paul Gosar (R-Ariz.) to offer his legislation as an amendment to the Help Efficient, Accessible, Low-cost, Timely Healthcare Act (H.R. 5) when it is considered on the House floor, which could happen as soon as this week.

The ADA has long advocated for a repeal of the antitrust exemption, arguing that it gives insurance companies an unfair advantage in the marketplace, and harms patients and providers.

The committee will allow for several other McCarran-Ferguson repeal amendments to H.R. 5, a bill that would limit medical malpractice awards and attorney fees, modify the statute of limitations and eliminate joint and several liability.

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March 14, 2012

HHS Rule Establishes Minimum Standards for Insurance Exchanges

On March 12, the Department of Health and Human Services released the final rule establishing the minimum standards that states, employers, and insurance carriers must meet to operate in the insurance exchanges required by the Patient Protection and Affordable Care Act.

A summary of the HHS rule is available here. The ADA continues to review all information pertaining to the exchanges as it is released to determine more precisely how they will affect individual dental practices once they are up and running in 2014. In the meantime, the association is keeping its affiliates up-to-date on health care reform developments through a series of conference calls with state executives.

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March 14, 2012

ADA Expands on Comments to Senate Committee

The ADA yesterday submitted an expanded statement for the record to a subcommittee of the Senate Health, Education, Labor and Pensions Committee. The expanded comments add to an earlier statement the association provided the Subcommittee on Primary Health and Aging for its Feb. 29 hearing titled “Dental Crisis in America: The Need to Expand Access.” This supplemental document addresses the question asked by Chairman Bernie Sanders (I-Vt.), who wanted to know what dentistry has done to alleviate the problem of access to dental care.

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