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American Dental Education Association

Volume 1, No. 50, February 25, 2020

Appeals Court Upholds Ruling Prohibiting Arkansas’ Medicaid Work Requirements

 

On Feb. 14, a federal court of appeals 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 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 Andy Beshear (D) rescinded Kentucky’s work requirement policy and in December.

 

Despite the ruling, the controversy over work requirements may continue. is appealing a ruling that struck down work requirements in their state, and a lawsuit is currently challenging work requirements in . and were recently granted permission by CMS to implement work requirements, and legislation to allow work requirements is also being considered in . To date, CMS has 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 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 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 . At issue is how to reach a compromise that would address surprise billing.

 

, 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, , 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 the Washington State Legislature. Both bills would make adjustments to the (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.

 

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.

 

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.

The 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.

 

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American Dental Education Association

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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

 

Higher Logic