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Advocacy report 2011

Association 2011 “initiatives in advocacy” engaged the U.S. Congress, government regulatory agencies, military and public health services and the United Nations in national and international discussions of oral health policy.

ADA’s mission statement (American Dental Association Strategic Plan: 2011-2014) positions the Association as “leading a unified profession through initiatives in advocacy, education, research and the development of standards.” While any measure of Association advocacy will necessarily fall short in terms of effect or extent, breadth or depth, the Division of Government & Public Affairs cited 2011 initiatives led or supported by the Association in collaboration with professional and public stakeholders that:

  • asserted the profession’s voice in Congress and the executive agencies on health care reform’s alternative dental health care provider demonstration projects, essential benefits package, medical device excise tax, health benefit exchanges, flexible spending account limitations, Form 1099 tax reporting and other provisions affecting dental patients and practices.
  • urged the congressional “super committee,” which ultimately failed to deliver a deficit reduction plan, to avoid drastic cuts to federal dental programs; told the would-be policy makers that residency program funding is important to rural area and pediatric dental capacity;
  • reversed for the second time in 15 years a Centers for Disease Control and Prevention attempt to downgrade the status of oral health within the agency;
  • secured $5.1 million for military dental research in the Fiscal Year 2012 defense appropriation and an $18 million increase in the Indian Health Service oral health appropriation;
  • prompted the Department of Health and Human Services to include oral health as one of the leading health indicators that will be used to evaluate the nation’s fundamental progress in achieving health promotion and disease prevention objectives outlined in Healthy People 2020;
  • reduced administrative burden on dentists and other health care providers enrolling in Medicare for the sole purpose of ordering Medicare-covered items or referring Medicare patients for covered services; the Association continues efforts to clarify the effect of Medicare’s Internet-based Provider, Enrollment, Chain and Ownership System (PECOS) on ordering/referring dentists;
  • opposed Drug Enforcement Administration plans to hike registration fees for prescribing controlled substances.

Legislation initiated or supported by the Association in the 112th Congress would:

  • repeal the McCarran-Ferguson antitrust exemption for the business of health insurance;
  • reform ERISA to help consumers receive full value of dental coverage and ensure health plan efficiency and transparency;
  • improve essential oral health care for lower-income individuals by breaking down barriers to care;
  • require states to provide oral health services to aged, blind or disabled individuals under the Medicaid program;
  • assist low-income children and adults in obtaining medically-necessary, pro-bono dental care;
  • include dental personnel within the definition of emergency response provider;
  • allow flexible spending account reimbursement for certain dental products;
  • extend the business expensing tax provision;
  • expand osteoporosis and related bone disease research;
  • enhance dental and health profession education and training “to strengthen the health care system’s response to domestic violence, dating violence, sexual assault and stalking.”

Congress isn’t moving much of this or any legislation. But the Association successfully advocated repeal of tax reporting and withholding laws that could have imposed additional tax burdens on dental practices small, large and corporate. Repeal in both cases was achieved with rare bipartisan congressional and White House support and in collaboration with business and professional partners.

On military matters, the Association secured U.S. Senate passage of a resolution congratulating the Army Dental Corps on its 100th anniversary and prevented introduction of legislation to downgrade the ranks of the Army and Air Force dental chiefs.

In other federal agency initiatives, the Association:

  • helped facilitate Centers for Disease Control and Prevention and Environmental Protection Agency introduction of a new federal fluoride standard;
  • met with Federal Trade Commission officials on scope of practice issues;
  • advised the Food and Drug Administration on regulation of so-called “modified risk” tobacco products;
  • offered comments to the Department of Health and Human Services on health plan, Medicare claims data, HIPAA and other proposed rules.  

The Association asserted a leading role in United Nations Environment Programme dental amalgam negotiations. The ADA advised State Department officials about professional “concerns” related to the continuing mercury treaty negotiations “with respect to the continued availability of dental amalgam.” The ADA also proposed oral health language for a U.N. political declaration on non-communicable diseases.

These selected “initiatives in advocacy” inform national and international health policy discussions with “oral health information that will help people be good stewards of their own health” (American Dental Association Strategic Plan: 2011-2014).