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American Dental Education Association


Volume 3, No. 21, November 21, 2023

Congress Keeps the Federal Government Open
 
On Sept. 30, President Biden signed a continuing resolution (Public Law 118-15 [ [link removed] ] ) to keep the federal government open from the beginning of fiscal year 2024 on Oct. 1, 2023, until Nov. 17, 2023. Last week, the Congress passed and the President signed H.R. 6363 [ [link removed] ] , a further continuing resolution that will keep the government open beyond that date.
 
In an unusual twist, the legislation provides two different expiration dates for appropriation bills for different departments and agencies of government. The bill that funds the Department of Health and Human Services and the Department of Education are extended until Feb. 2, 2024, along with seven other appropriations bills. Four other bills are extended through Jan. 19, 2024.

House Consideration of the Labor, HHS and Education Appropriations Bill
 
The U.S. House of Representatives is currently considering on the floor H.R. 5894 [ [link removed] ] , a bill making appropriations for fiscal year (FY) 2024 for the Departments of Labor, Health and Human Services (HHS), and Education (ED). It began deliberations on Nov. 14 and will resume next week after the Thanksgiving recess. The budget agreement reached earlier this year makes severe cuts to domestic programs: the overall bill cuts $60.3 billion (29%) below the funding levels in FY 2023 from the programs under the Subcommittee’s jurisdiction. Of this amount, $14 billion is cut from HHS programs and $12 billion from ED. The President has threatened to veto [ [link removed] ] the bill.
 
Higher education takes substantial reductions in its budget: the Student Aid Administration is cut $264.7 million below the FY 2023 level for salaries and expenses. The White House singled out this reduction, noting that “Borrower communications and call center support would be severely curtailed and possibly eliminated…” at a time when loan repayment has restarted and many borrowers have questions. Programs eliminated are the Federal Supplemental Educational Opportunity Grants and Federal Work-Study. The higher education programs overall are cut by $758.8 million with some programs being eliminated altogether. No funds are provided for overseas programs, the Graduate Assistance in Areas of National Need and Teacher Quality Partnership Grants.
 
The Oral Health Training Programs at HHS are funded at the FY 2023 levels, as they were in the Senate bill as well, with one glaring exception. The Ryan White HIV/AIDS Program Part F, which includes the Dental Reimbursement Program (DRP) and the Community-Based Dental Partnership Program, was not funded. The DRP program is a reimbursement program for dental school clinics that treat persons living with HIV/AIDS to educate future dentists in caring for these patients.
 
ADEA will continue to report on the progress of both the House and Senate versions of this appropriations bill, and the progress toward agreement on a final version before Feb. 2.

CMS Issues Final 2024 Medicare Physician Fee Schedule, Includes Dental and Oral Health Policy Changes
 
The Centers for Medicare & Medicaid Services (CMS) has released the 2024 Medicare Physician Fee Schedule Final Rule [ [link removed] ] , which is a complete listing of fees used by Medicare to pay doctors or other providers and suppliers. This comprehensive listing of fee maximums, which also contains policy changes for the upcoming year, is used to reimburse a physician and/or other providers on a fee-for-service basis. The fee schedule is effective on or after Jan. 1, 2024.
 
Last year, CMS statutorily established that “Medicare payment under Parts A and B could be made when dental services are furnished in either the inpatient or outpatient setting under particular kinds of circumstances.” Specifically, the dental services had to be “inextricably linked to other covered medical services, such as dental exams and necessary treatments prior to organ transplants (including stem cell and bone marrow transplants), cardiac valve replacements, and valvuloplasty procedures."
 
For the upcoming fiscal year 2024, CMS has done the following:
 1. It has codified the previously finalized payment policy for dental services for head and neck cancer treatments, whether primary or metastatic.
 2. It has codified allowing Medicare Part A and Part B payment for dental or oral examination performed as part of a comprehensive workup prior to medically necessary diagnostic and treatment services, to eliminate an oral or dental infection prior to, or contemporaneously with, those treatment services, and to address dental or oral complications after radiation, chemotherapy and/or surgery when used in the treatment of head and neck cancer.
 3. It has finalized its proposal to permit payment for certain dental services inextricably linked to other covered services used to treat cancer prior to, or during:
    a. Chemotherapy services,
    b. Chimeric Antigen Receptor T- (CAR-T) Cell therapy or
    c. The use of high-dose bone modifying agents (antiresorptive therapy).


The rule includes assurances that Medicare will pay the same rate for telehealth services delivered at home as those delivered in a doctor’s office, delays requirements that patients visit a doctor in-person within six months prior to starting mental health services online and continues to allow teaching physicians to bill Medicare if they use telehealth to supervise a resident performing care.
 
The rule also allows physicians to continue using their office address for telehealth claims, rather than listing their home address. This protects provider privacy and removes a barrier to delivering telehealth for clinicians working from home.

Department of Education Announces FAFSA Release Date for 2024–2025 School Year
 
The Department of Education (ED) confirmed [ [link removed] ] that the Free Application for Federal Student Aid (FAFSA) will open no later than Dec. 31. Usually, the FAFSA opens on Oct. 1 to give students ample time to complete the application; however, this year’s significant delay in the release of the FAFSA was due to changes in how student aid is calculated. ED plans to return to the Oct. 1 FAFSA release date for the 2025–2026 school year.

Missouri Passes Emergency Rule, Proposes Rule to Govern New Health Care Provider Loan Repayment Program
 
The Missouri Department of Health and Senior Services has passed an emergency rule [ [link removed] ] and proposed a long-term rule [ [link removed] ] to help govern a health care provider student loan repayment program that was created by legislation [ [link removed] ] that became effective in August 2023. The legislation authorizes the Department to determine the health professionals and practitioners who will receive assistance based on evidence associated with the greatest needs in the best interests of the public. The emergency and proposed rules are identical and outline the following criteria for selection of health professionals:
 • The greatest degree of need for health professional services, using a workforce shortage analysis by qualifying health professional type to population ratios and Health Professional Shortage Area scoring, if available;
 • Applicant’s financial need based on adjusted gross income and number of dependents as filed on their most recent federal tax return to determine the applicant’s federal poverty level (FPL) percentage; and
 • A lottery, if the number of applicants exceeds the amount of appropriated funding and there are applicants demonstrating the same need in their health professional category and equal FPL percentage.

Recipients of awards will be required to enter a two-year contract and fulfill a “service obligation” as detailed by their contract and approved by the Department. Practitioners with a doctorate degree will be awarded up to $65,000. Those with a bachelor's or master's degree will be awarded up to $35,000, practitioners with an associate degree will be awarded up to $10,000.
 
The emergency rule is already in effect. Comments about the proposed rule must be sent within 30 days of the date of rule publication, which was Nov. 15.

ADEA Advocacy in Action
This appears weekly in the ADEA Advocate to summarize and provide direct links to recent advocacy actions taken by ADEA. Please let us know what you think and how we might improve its usefulness.
 
Issues and Resources
 • ADEA report [ [link removed] ] on teledentistry
 • ADEA report [ [link removed] ] on the Impact of the COVID-19 Pandemic on U.S. Dental Schools
 • ADEA policy brief [ [link removed] ] regarding overprescription of antibiotics
 • For a full list of ADEA memos, briefs and letters click here [ [link removed] ] .

Key Federal Issues [ [link removed] ]

ADEA U.S. Interactive Legislative and Regulatory Tracking Map [ [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.
 
©2023
American Dental Education Association
655 K Street, NW, Suite 800
Washington, DC 20001
Tel: 202-289-7201
Website: www.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 and Advocacy
 
Phillip Mauller, M.P.S.
ADEA Director of State Relations and Advocacy
 
Varsha Menon
ADEA Program Manager for Advocacy and Government Relations
 
Contact Us:
[email protected] [ mailto:[email protected] ]

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