ADA advocacy highlights from 2017 include issues affecting new dentists

From repealing burdensome Medicare regulations to working to include dentistry in the various pro-business tax reform provisions, 2017 was a busy year for the Association’s Washington office, according to ADA News.

Here are some of the key advocacy issues the ADA addressed in 2017:

For the dental practice

Medicare regulations: The ADA worked with the Centers for Medicare and Medicaid Services to reverse the enrollment requirements for dentists under Medicare Part D and Part C (Medicare Advantage). In November, CMS issued a proposed rule that would remove the Medicare Part D enrollment requirement for dentists and rescind the enrollment requirement for dentists to provide supplemental services to patients enrolled in Part C. The ADA believes this is good for patients because more dentists will likely enroll in these insurance programs without the duplicate paperwork requirements. The rule is expected to be finalized in 2018.

McCarran-Ferguson reform: On March 22, the House of Representatives passed the Competitive Health Insurance Reform Act of 2017, H.R. 372, by a vote of 416-7. The bill would amend the McCarran-Ferguson Act to authorize the Federal Trade Commission and the Justice Department to enforce federal antitrust laws against health insurance companies. The ADA continues to work to secure a Senate sponsor for a companion bill to H.R. 372. Find out more at ADA.org/McF.

For the dental profession

Federal tax reform: The ADA successfully advocated to ensure the dental profession will benefit from the tax reform law that Congress enacted at the end of 2017. The ADA believes the following provisions will positively affect a majority of dental practices:

  • Improving the cash accounting allowance by allowing corporations and partnerships with corporate partners with average gross receipts up to $25 million to use cash accounting. This would also allow farm corporations and partnerships with gross receipts of up to $25 million to use cash accounting. Eligible businesses could use cash accounting even if they had inventories.
  • Improving Section 179 expensing by expanding businesses’ ability to immediately expense some of the costs of qualifying property such as off-the-shelf computer software and some real property. Currently $500,000 can be expensed unless more than $2 million in property is bought. Under the final tax bill, as much as $1 million could be expensed and expensing would be expanded to include furniture, as well as nonresidential roofs, heating and air conditioning systems, and fire and alarm systems.
  • Retaining the student loan interest deduction at its current levels. The bill did not include a tax on tuition waivers that graduate students receive from education institutions as income; previous versions of the tax bill had repealed this deduction and proposed a tuition waiver tax for graduate students.
  • Providing the first-ever deduction for all pass-through entities, including S corporations and sole proprietorships. The deduction is extended to certain professional service businesses, including dentist practices. It would only be fully available for service businesses with income of $157,500 or less for individual filers or $315,000 for joint/married filers and would phase out for incomes greater than those thresholds.

For more information, visit ADA.org/taxreform.

Indian Health Service: The ADA remains committed to increasing access to dental services for tribal populations. On June 13, then-ADA President-elect Joseph Crowley testified before the Senate Indian Affairs Committee in support of the “medical credentialing system” provision of S. 1250 — the Restoring Accountability in the Indian Health Service Act of 2017 bill. That provision calls for the Indian Health Service to implement a centralized system to credential licensed health care professionals who seek to provide health care services at any IHS facility. On June 21, the ADA submitted a statement for the record to the House Subcommittee on Indian, Insular and Alaska Native Affairs, Committee on Natural Resources, in support of H.R. 2662, the companion bill for S. 1250.

Appropriations for federal dental programs: The ADA advocated for increased funding for federal dental programs and on Sept. 14 the House of Representatives passed an omnibus spending package for fiscal year 2018. The package includes: $432 million ($7 million increase) for the National Institute of Dental and Craniofacial Research; $186 million ($3 million increase) for the Indian Health Service’s oral health program; and $32.8 million ($2.5 million increase) for Area Health Education Centers that support programs to help patients find treatment outside of hospital emergency rooms. The report accompanying the AHEC funding encouraged the Health Resources and Services Administration to work with state dental associations with regard to patient referral programs, supporting a key initiative in the ADA’s Action for Dental Health program.

For patients and the public

Health care reform: Though Congress did not pass a health care reform bill in 2017, the ADA maintained strong opposition to the proposed changes to Medicaid that would have negatively impacted access to dental services. This included opposing efforts to change Medicaid into a federal block grant program. ADA Letters and Action Alerts on Health Care Reform are available at ADA.org/healthreform.

Action for Dental Health bill: On June 29, the House Energy and Commerce Subcommittee on Health unanimously passed the Action for Dental Health Act of 2017. The bill, H.R. 2422, was introduced by Rep. Robin Kelly, D-Ill., and Rep. Mike Simpson, R-Idaho, and calls for Congress to authorize additional oral health promotion and disease prevention programs. On May 17, Dr. Cheryl D. Watson-Lowry testified on behalf of the ADA’s Action for Dental Health initiative during the subcommittee’s hearing on the bill.

Environmental Protection Agency: On June 22 Dr. Crowley met with EPA officials to discuss the agency’s rule governing discharge of amalgam waste into municipal water systems. The rule had been in a precarious state since Jan. 20, when it was withdrawn in accordance with a White House memorandum. The final rule, which the EPA published in June, closely follows the ADA’s best management practices for amalgam waste and meets the nine principles established by the ADA House of Delegates as a condition for supporting a national rule. Find out more at ADA.org/recycleamalgam.

Noncovered services: The Dental and Optometric Care Access Act or the “DOC Access Act” (H.R. 1606) was introduced in the 115th Congress by Rep. Earl “Buddy” Carter of Georgia. This noncovered services bill prohibits all health plans offering a dental or vision benefit from dictating what a doctor may charge a plan enrollee for items or services not covered by the plan.

Children’s Health Insurance Program: The ADA remains engaged with the oral health community in asking Congress to take action to reauthorize the Children’s Health Insurance Program for at least five years. CHIP is a critical safety net for American children who do not qualify for Medicaid, but whose families would struggle to afford private coverage, particularly dental coverage. The ADA has joined with the Organized Dentistry Coalition and numerous other stakeholder groups in this effort. Find out more at ADA.org/CHIP.

Opioid abuse: The ADA continues to be proactive on opioids awareness by providing statements for congressional hearings and commenting on a range of federal proposals and requests for information about dentistry’s role in preventing opioid abuse. For example, the ADA helped convince the FDA to institute a prescriber education and outreach strategy to deal with the category of short acting opioids that dentists sometimes prescribe for acute pain. The ADA is also asking the Centers for Disease Control and Prevention and other agencies to elevate the management of acute pain into their prescriber education and outreach activities. The ADA has also worked with the Partnership for Drug-Free Kids and other groups to raise prescriber awareness of the opioid crisis and promote more judicious prescribing of opioid pain relievers. Find out more ADA.org/opioids.

Stay up-to-date with the ADA’s advocacy efforts by visiting ADA.org/advocacy.

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