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American Dental Education Association
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Volume 1, No. 50, February 25, 2020
Appeals Court Upholds Ruling Prohibiting Arkansas’ Medicaid Work Requirements
On Feb. 14, a federal court of appeals upheld the ruling [ [link removed] ] of a lower court that prohibited Arkansas from requiring some Medicaid beneficiaries to meet minimum work requirements in order to receive benefits. Regular readers of the ADEA Advocate may recall that Justice James Boasberg struck down Arkansas’ policy and a similar policy in Kentucky in March 2019 [ [link removed] ] on the grounds that the decision by the Centers for Medicare & Medicaid Services (CMS) to allow the requirements was “arbitrary and capricious because it did not address . . . how the project would implicate the ‘core’ objective of Medicaid: the provision of medical coverage to the needy.”
The court of appeals ruling only applies to Arkansas, as Kentucky’s newly elected Gov. Andy Beshear (D) rescinded Kentucky’s work requirement policy and pulled out of the lawsuit [ [link removed] ] in December.
Despite the ruling, the controversy over work requirements may continue. New Hampshire [ [link removed] ] is appealing a ruling that struck down work requirements in their state, and a lawsuit is currently challenging work requirements in Michigan [ [link removed] ] . South Carolina [ [link removed] ] and Utah [ [link removed] ] were recently granted permission by CMS to implement work requirements, and legislation to allow work requirements is also being considered in Iowa [ [link removed] ] . To date, CMS has approved work requirements [ [link removed] ] in 10 states, and eight additional states have submitted waivers requesting permission to implement the policy.
House Committee Democrats Object to Proposed Title IX Regulations
Last week, in a letter [ [link removed] to DeVos-DoED re Title IX.pdf ] to U.S. Education Secretary Betsy DeVos, Democrats in the U.S. House of Representatives’ Oversight and Investigation Committee objected to the U.S. Department of Education’s (ED) proposed overhaul of the regulations controlling Title IX. In the letter, Dems cited concerns over the ED’s flawed cost-benefit analysis and lack of transparency surrounding the basis of the regulation changes.
The Title IX regulation changes [ [link removed] ] were first proposed in November 2018. The Trump administration is currently working towards finalizing the proposed regulations prior to the start of the new school year.
ED under President Obama issued new guidance to colleges that made clear they were expected to investigate sexual harassment and assault allegations under Title IX, the 1972 law that prohibits discrimination on the basis of sex in any federally funded education program. DeVos said the Obama administration guidance didn’t do enough to protect the rights of accused students and, in 2018, released draft regulations to govern how colleges handle misconduct complaints.
Under the Trump administration’s proposal, schools could raise the burden of proof needed to find a student responsible and students would be guaranteed the right to indirectly cross-exam each other. The divisiveness of these proposed regulations was apparent in the 100,000 comments filed in response to the proposed regulations.
Democrats and Republicans Want a Fix to Surprise Billing
In a rare instance of bipartisanship, “surprise billing” is a point of concern for both Republicans and Democrats—and both parties want to fix it. So far negotiations between both parties and the U.S. House of Representative’s three committees that have health care jurisdiction are at an impasse [ [link removed] ] . At issue is how to reach a compromise that would address surprise billing.
H.R. 5826 [ [link removed] ] , Consumer Protections Against Surprise Medical Bills Act of 2020, a bipartisan bill was introduced and passed by the House Committee on Ways and Means. It was supported by doctors and hospitals, and would require patients, doctors and/or hospitals to engage in arbitration to resolve billing disputes. Insurers, unions and consumer groups do not support this bill because they believe it will only cause cost increases as services and products will be priced with possible arbitration in mind.
However, H.R. 3630 [ [link removed] ] , No Surprises Act, also a bipartisan effort from the House Committee on Energy and Commerce, would settle disputes by restricting payments to providers to a federal benchmark payment rate that is based on median local in-network rates. Insurers, unions and consumer groups support this bill, but doctors and hospitals worry that it would lead to significant payment cuts.
The best chance of passing a fix comes in May, when Congress will have to renew funding for community health centers and other health programs. Eliminating surprise billing could provide significant projected savings to the federal government that could help pay for the fix and increase the likelihood of passage in the Senate.
Children’s Oral Health Bills Moving Through Washington Legislature
Two bills that could potentially expand children’s access to oral health care providers are currently moving through [ [link removed] ] the Washington State Legislature. Both bills would make adjustments to the Access to Baby & Child Dentistry Program [ [link removed] ] (ABCD), a Washington state program that offers enhanced fees to service providers of Medicaid eligible children under the age of six who participate in the program. The program contracts with the University of Washington School of Dentistry and the Arcora Foundation to provide management services, recruitment and training of providers. All providers must be ABCD certified to participate in the program.
HB 2905 [ [link removed] ] passed the State House on Feb. 16. This bill would require the program to develop a local access to program fund allocation formula, key deliverables and target metrics for increased outreach and provider engagement and support. The goals of the development of the formula, deliverables and metrics are to reduce racial and ethnic disparities in access to care and oral health outcomes, and to increase the percentage of Medicaid-enrolled children under the age of two accessing dental care.
SB 5976 [ [link removed] ] passed the State Senate on Feb. 12. This bill would attempt to expand coverage under the ABCD program to children with disabilities up the age of 13. Legislation was passed in 2018 that required the ABCD program to begin providing coverage to this population, but the bill’s language made it difficult to receive approval for the expansion from the Centers for Medicare & Medicaid Services (CMS). The bill would adjust the language of current statute to help make CMS approval more likely.
ADEA State Calendar [ [link removed] ]
ADEA Washington Calendar [ [link removed] ]
ADEA U.S. Interactive Legislative and Regulatory Tracking Map [ [link removed] ]
Key Federal Issues [ [link removed] ]
Key State Issues [ [link removed] ]
The ADEA Advocate [ [link removed] ] is published weekly. Its purpose is to keep ADEA members abreast of federal and state issues and events of interest to the academic dentistry and the dental and research communities.
©2020
American Dental Education Association
655 K Street, NW, Suite 800
Washington, DC 20001
202-289-7201, adea.org [ [link removed] ]
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B. Timothy Leeth, CPA
ADEA Chief Advocacy Officer
Bridgette DeHart, J.D.
ADEA Director of Federal Relations
Phillip Mauller, M.P.S.
ADEA Director of State Relations and Advocacy
Brian Robinson
ADEA Program Manager for Advocacy and Government Relations
Ambika R. Srivastava, M.P.H.
ADEA/Sunstar Americas, Inc./Jack Bresch Legislative Intern
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