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Volume 1, No. 53, March 17, 2020

Congress and Administration Prepare Second COVID-19 Bill
 
On March 11 House Democrats unveiled a second piece of legislation to address the continuing coronavirus response. The portion of the bill, H.R. 6201 [ [link removed] ] , the “Families First Coronavirus Response Act, that may directly affect dental school clinics is a temporary 6.2% increase in each States Federal medical assistance percentage (FMAP). For Puerto Rico, the bill would provide an additional Medicaid allotment of $128.7 million in FY 2020 and $127.9 million in FY 2021.
 
Other provisions seek to ensure that elementary school students qualifying for free or reduced-cost school lunches will still receive nutritional support if their schools close. It also includes additional flexibility in the Supplemental Nutritional Assistance Program (SNAP) so that low-income jobless workers continue to receive benefits. Another provision requires that any health insurer shall not impose any cost sharing (copays or deductibles) on testing for the Coronavirus. Other provisions carry this prohibition to Medicare and Medicaid (including CHIP) beneficiaries, active duty military, veterans, and Federal employees to receive a test for the Coronavirus without a copay.
 
At this writing the House of Representatives and the White House have agreed to a bipartisan bill that can pass both Houses of Congress and be signed by the President. The House passed the compromise by a wide margin early on Saturday morning and the Senate is expected to follow suit on Monday. We will provide updates on this legislation and other developments in this fluid situation.

U.S. Senate Overturns Education Department’s Borrower Defense Rule Changes
 
On March 11, the U.S. Senate passed a resolution that overturns regulations [ [link removed] ] issued by U.S. Education Secretary Betsy DeVos. The House Democrats passed a similar resolution earlier this year.
 
Last year, DeVos issued an overhaul of the borrower defense regulations. These regulations provide a path for students who are defrauded or misled by their colleges to get their federal loans discharged, but the new rule significantly tightens standards for debt relief. The U.S. Department of Education estimates that the new regulation would produce $11 billion dollars in savings for taxpayers by reducing loan forgiveness.
 
The new regulation was overturned under the Congressional Review Act of 1996, which allows lawmakers to block new regulations with simple majorities in the House and Senate.
 
Democrats called the rule unfair and noted that it favored for-profit colleges, which is the sector that spurred most of the claims under the Obama-era borrower defense rule.
 
The Trump Administration expressed its intent to veto the resolution. A two-thirds majority is needed to overturn the President’s veto. However, overturning the President’s veto is unlikely because two-thirds of Congress will likely not oppose the veto. Therefore, the regulation will go into effect.

Licensure Portability Trending in Several States
 
Last year, Arizona [ [link removed] ] became the first—and so far only—state to grant licensure portability to any state resident who had held a license in another jurisdiction that is in good standing for at least one year. Inspired by passage of this monumental legislation, several other states have taken steps to implement a similar policy.
 
On March 11, the Oklahoma [ [link removed] ] Senate passed a bill that would require all occupational licensing boards to issue a license to anyone who establishes residence in the state or who is married to an active-duty member of the military and has held a license in another jurisdiction that is in good standing for at least one year. Similar to the Arizona law, the bill would exempt anyone who is subject to a complaint or other specified disciplinary measures.
 
A similar bill passed the Missouri [ [link removed] ] House in January and, earlier this month, passed a Senate committee. Unlike the Arizona law and the Oklahoma bill, however, the Missouri bill would not limit portability to state residents as a licensing board would be required to waive any examination, educational or experience requirements for licensure for anyone who has held a license for at least one year, if the board determines minimum education and clinical supervision requirements were met in the other jurisdiction.
 
Other states where reciprocity legislation is being considered include Iowa [ [link removed] ] , Ohio [ [link removed] ] and Idaho [ [link removed] ] . Idaho’s bill passed the state Senate on March 11, but has more restrictions than reciprocity bills in other states as the bill would still require applicants to demonstrate competency “through methods determined by the licensing board,” including the passage of an examination.
 
More limited portability for members of the military and their spouses was recently enacted in Ohio [ [link removed] ] . On January 27, Gov. Mike Dewine (R), signed a bill to grant temporary licensure to members of the military and their spouses who hold licenses in other jurisdictions. This could be an area more states examine following the issuance of recent report from the U.S. Department of Defense [ [link removed] ] , outlining recommendations on portability for military spouses.

Oklahoma Becomes First State to Apply for Healthy Adult Opportunity Block Grant
 
On March 6, Oklahoma [ [link removed] ] became the first state to apply for a block grant under the Healthy Adult Opportunity (HAO), a guidance from the Centers for Medicare & Medicaid Services (CMS). Oklahoma is one of 14 states that has not expanded Medicaid, and if approved, would use the block grant [ [link removed] ] to implement Medicaid expansion that also includes work requirements and premiums for enrollees.
 
Readers of the ADEA Advocate may recall that earlier this year, we reported that under the HAO guidance [ [link removed] ] , CMS outlined terms it would use to approve voluntary waiver requests from states that wish to have a portion of their Medicaid funds distributed in the form of a block grant [ [link removed] ] rather than the traditional open-ended, cost-sharing arrangement between states and the federal government. In exchange for receiving a fixed amount of funding in the form of a block grant, states would be granted greater flexibility in administering their programs. It is important to note that any funds distributed as a block grant under the HAO could only be used to provide coverage for adult Medicaid populations under the age of 65 who are not disabled, not in long-term care or not eligible under a state plan. The most common group of Medicaid patients who meet this definition are individuals included under Medicaid expansion.
 
Some have posited that Oklahoma Gov. Kevin Stitt (R) filed the application in attempt to get ahead of a Medicaid expansion ballot initiative that would call for the state to implement Medicaid expansion without fixed funding, work requirements or premiums. Support for the ballot initiative has been demonstrated in polls, while Gov. Stitt opposes the initiative.

CMS Covers Covid-19 Telehealth Visits
 
The Centers for Medicare & Medicaid Services (CMS) issued a fact sheet [ [link removed] ] and FAQ [ [link removed] ] to offer guidance to health care providers regarding the coronavirus (COVID-19) telehealth benefits for those in the Medicare program.
 
Many Medicare patients are at higher risk for complications from COVID-19. The inclusion of telehealth visits for COVID-19 expands access to health care providers for many vulnerable populations, including the elderly, those with disabilities and those in rural areas. Having access to telehealth visits will also help safeguard the public from exposure to possible cases of COVID-19 and decrease the number of people in emergency rooms. Medicare patients will be able to reach out to their doctors with questions about symptoms they are experiencing as well as receive advice about whether further action is needed.
 
Approval for the expansion of telehealth benefits to include coverage for COVID-19 was part of the emergency coronavirus supplemental legislation recently signed into law.

ADEA State Calendar [ [link removed] ]

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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
 
[email protected] [ mailto:[email protected]?subject=State%20Update%3A%20 ]

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