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American Dental Education Association


Volume 3, No. 36, April 2, 2024

CMS Final Rule Simplifies Medicaid and CHIP Enrollment and Renewal
 
The Centers for Medicare & Medicaid Services (CMS) has introduced a final rule [ [link removed] ] aimed at streamlining the enrollment and renewal processes for Medicaid and the Children’s Health Insurance Program (CHIP) with the objective of eliminating coverage interruptions. Named the Streamlining the Medicaid, Children’s Health Insurance Program, and Basic Health Program Application, Eligibility Determination, Enrollment, and Renewal Processes rule, it seeks to standardize procedures nationwide while incorporating consumer protections outlined in the Affordable Care Act. Recent numbers indicate that, as of November 2023, approximately 85.8 million individuals were enrolled in either Medicaid or CHIP.
 
The regulation implements significant changes, including the removal of annual and lifetime limits on children’s coverage and ensuring continuous access to CHIP, regardless of a family's ability to pay premiums. Moreover, waiting periods for CHIP coverage have been eliminated. Additionally, measures are in place to simplify the transition of children from Medicaid to CHIP as family income increases. The rule mandates that states provide individuals with at least 15 days to furnish additional information during initial applications and 30 days for renewal documentation. It also restricts states from conducting renewals more than once annually and requiring in-person interviews for older adults and individuals with disabilities.
 
The rule is set to take effect within 60 days of its official announcement.

Sens. Heinrich and Casey Introduce the PRO-HEAL Act
 
U.S. Sens. Martin Heinrich (D-N.M.) and Bob Casey (D-Pa.) introduced the Providing Resources and Opportunities for Health Education and Learning (PRO-HEAL) Act (S. 4031) [ [link removed] ] . This legislation aims to address the health care workforce shortage and promote pathways to health care careers.
 
The PRO-HEAL Act would authorize new five-year Health Resources and Services Administration (HRSA) grants to support the expansion or establishment of health care provider pathway programs by states and higher education institutions. Additionally, it allocates $215 million to fund programs for eligible entities.
 
In addition to pathway programs for dentists, pathway programs for both medical and osteopathic medicine doctors, physician assistants, nurse practitioners, nurses, emergency medical technicians and behavioral health providers are also considered eligible entities under this bill.
 
Though pathway programs for allied oral health professionals are not eligible entities, the bill does allow HRSA, at its discretion, to “add to the list of health care professionals eligible for health care provider pipeline programs . . . based on areas of need and shortages across the Nation.”
 
The bill also establishes priority considerations in awarding grants. Specifically, the following priorities are to be taken into consideration:
 • Programs targeting under-served or rural communities;
 • Programs designed to increase the number of health care professionals who are primary care providers; or
 • Eligible entities that intend to recruit mostly individuals to participate in the health care provider pipeline program from within the same state as the eligible entity or in which the eligible entity is located.

Florida Gov. Signs Bill That Creates New Health Care Workforce Programs and Expands Loan Repayment
 
On March 21, Gov. Ron DeSantis (R) signed a bill [ [link removed] ] that will create several new programs to support the state’s health care workforce and also expand the state’s Dental Student Loan Repayment Program. While not all the changes will directly impact oral health professionals, many will. Summaries of those changes can be found below.
 
First, the legislation proposes multiple changes to the state’s Dental Student Loan Repayment Program that include:
 • Expanding the program to include dental hygienists;
 • Expanding eligibility to include private dental practices that are located in dental health professional shortage areas (HPSAs) as eligible practice locations for dentists and dental hygienists;
 • Requiring dentists and dental hygienists who participate in the program to also volunteer 25 hours per year, providing dental services in a free clinic that is located in a dental HPSA or a medically underserved area, through another volunteer program operated by the state—pursuant to part IV of chapter 110 [ [link removed] ] , or through a pro bono program approved by the Florida Board of Dentistry;
 • Specifying that the annual award for a qualifying dentist or dental hygienist is 20% of his or her principal loan amount at the time that he or she applies for the program, but may not be more than $50,000 per year for dentists or $7,500 per year for dental hygienists;
 • Specifying that a dentist or dental hygienist may receive up to five such awards and that the awards are not required to be awarded in consecutive years;
 • Eliminating language that limits participants to no more than 10 per fiscal year;
 • Clarifying that the program is meant to support the state’s Medicaid program; and
 • Appropriating $8 million for the program for the 2024-2025 fiscal year.

Secondly, the bill would also create a preceptor program known as the Training, Education and Clinicals in Health (TEACH) funding program. The program would provide a high-quality educational experience while supporting participating federally qualified health centers, community mental health centers, rural health clinics and certified community behavioral health clinics by offsetting administrative costs and loss of revenue associated with training residents and students to become licensed health care practitioners. Under the TEACH funding program, the Florida Area Health Care Administration (AHCA) would be required to enter into an agreement with qualified facilities that agree to provide appropriate supervision or precepting of specified health care professionals, including dental residents, dental students and dental hygiene students. Facilities that participate in the program are eligible for hourly reimbursement rates of $50 for dental residents, $22 for dental students and $15 for dental hygiene students.
Effective Oct. 1, 2024, the sums of $14,888,903 in recurring funds from the General Revenue Fund and $20,036,979 in recurring funds from the Medical Care Trust Fund would be appropriated to the Florida AHCA to provide a Medicaid reimbursement rate increase for dental care services.
 
Finally, the bill would also create the Dr. and Mrs. Alfonse and Kathleen Cinotti Health Care Screening and Services Grant Program to fund the provisions of no-cost health care screenings or services for the public by nonprofit entities. Dental screenings are included among eligible expenses under the grant program.
 
West Virginia Governor Signs Bill Increasing Medicaid Spending Cap on Dentures
 
West Virginia Gov. Jim Justice (R) signed a bill [ [link removed] ] that will increase the state’s Medicaid spending cap for dentures. The annual cap will increase from $1,000 to $2,000 for adult patients enrolled in the state’s Medicaid program.

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 Senior Director of State Relations and Advocacy
 
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[email protected] [ mailto:[email protected] ]

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