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American Dental Education Association

Volume 3, No. 57, October 2, 2024
Congress Passes Continuing Resolution for Federal Government to Remain Open

 

In an unusually swift and bipartisan action, Congress late last week passed and President Biden signed the , which will keep the federal government in operation through Dec. 20, giving Congress time after the election to enact the 12 appropriations bills.

 

Under the terms and conditions of a continuing resolution, departments and agencies are prohibited from terminating any program or project and from starting any new program or project that was not carried out in the last fiscal year. Governmental activities simply continue as they have until there is new authority enacted in the annual appropriations legislation.

 

Telehealth Extension Bill Passes Energy and Commerce Committee

 

, successfully passed out of the U.S. House of Representatives’ Committee on Energy and Commerce on Sept. 18, extending telehealth provisions that were initially implemented during the COVID-19 pandemic and were set to expire at the end of this year. While the bill only extends these provisions until the end of 2026, it received unanimous support with a vote of 41-0, marking a significant achievement for lawmakers. U.S. Rep. Buddy Carter (R-GA), the bill’s sponsor, expressed disappointment that the telehealth flexibilities would not be made permanent but emphasized the importance of ensuring that these services remain accessible.

 

The legislation would continue to allow telehealth to take place regardless of location (both geographic and type of site), allowing the larger list of providers to continue to provide services via telehealth and be reimbursed by Medicare—including federally qualified health centers, rural health clinics and occupational and physical therapists—and continuing coverage of audio-only services for those with limited internet access. The prior in-person visit requirements for mental health visits that do not meet the geographic requirement or exceptions to it will also continue to be delayed.

 

The legislation includes several key components aimed at enhancing telehealth access, particularly for non-English speakers. Specifically, it instructs the Department of Health and Human Services (HHS) to issue and disseminate (or update, if something currently exists) guidance on best practices for facilitating and integrating use of interpreters during a telehealth encounter.

 

The bill will also require modifiers to be used in certain instances. No later than Jan. 1, 2026, HHS will have to establish requirements for the use of a code or modifier when: 1) services via telehealth are provided by a practitioner that contracts with an entity that owns a virtual platform used to provide the service, or 2) when the practitioner has a payment arrangement with an entity for the use of a virtual platform used to provide such services and the claims for telehealth services are billed incident to a practitioner’s professional service.

 

In addition to telehealth provisions, the legislation aims to improve transparency among pharmacy benefit managers by requiring clearer contractual practices and separating their compensation from drug costs.

 

The next step for the bill is potential inclusion in a larger spending package that will go before the full House.

 

Louisiana Legislators Postpone Extending DentaQuest’s Medicaid Dental Contract After Network Coverage Complaints

 

At a Sept. 20 hearing, the Louisiana House Joint Budget Committee postponed extending DentaQuest’s Medicaid dental contract, seeking more data on coverage issues after concerns were raised about limited access to care. Some residents reportedly have to travel as much as 75 miles to find an in-network dentist. Kim Sullivan, Medicaid Director for the Louisiana Department of Health, acknowledged a statewide shortage of dentists, describing certain regions as “dental deserts.”

 

Lawmakers DentaQuest for inadequate network coverage and high claim rejection rates, which have driven many dentists out of the network. State Rep. Tony Bacala (R) labeled the company a “bad actor,” noting that another provider, MCNA, facilitated twice as many visits. DentaQuest representatives attributed the rejections to improper documentation, while the company highlighted efforts to improve services and recruit more specialists. Lawmakers requested additional data before reconsidering the contract in October.

 

Pennsylvania Bill Would Offer More Medicaid Dental Coverage for Adults

 

In 2011, Pennsylvania’s Department of Human Services cut most dental services for adults on Medicaid to save costs, but lawmakers and advocates are now pushing to reverse that decision through . Medicaid in Pennsylvania currently covers only basic services, like exams and filings, leaving more complex procedures, such as root canals and crowns, not covered without special exceptions.

 

Advocates that the 2011 changes have led to higher medical costs, with patients seeking emergency room care for preventable dental issues, costing the state an estimated $35 million annually. HB 1147, passed by the state House, would restore pre-2011 Medicaid dental benefits at an estimated cost of $155 million per year, with Pennsylvania covering $40 million while federal-matching funds would cover the rest.

 

The bill is now stalled in the Republican-controlled state Senate, though supporters stress it would not only improve health outcomes but also boost quality of life for individuals with untreated dental issues.

 

Michigan Bill Would Require Health Professional Applicants Renewing Licenses to Complete Training on Implicit Bias

 

Michigan lawmakers recently introduced , which seeks to amend licensing requirements by mandating that applicants complete a specified number of training hours on implicit bias before renewing their professional licenses or registrations. This requirement applies to the license or registration cycle immediately preceding the renewal application, aiming to ensure that professionals are better equipped to address and mitigate bias in their practices.

 

The ADEA Advocate Will Take a Break Until Congress Returns

 

Congress has recessed until after the Nov. 5 election; it will return the week of Nov. 11. The ADEA Advocate will publish again when Congress returns with information about the remaining legislative work to be done during the lame duck session following the election, and what we know of plans for the new Congress that will convene in January 2025.

 

Please exercise your right to vote on Nov. 5.

 

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 on teledentistry
  • ADEA on the Impact of the COVID-19 Pandemic on U.S. Dental Schools
  • ADEA policy regarding overprescription of antibiotics
  • For a full list of ADEA memos, briefs and letters click .

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 and Advocacy

 

Phillip Mauller, M.P.S.

ADEA Senior Director of State Relations and Advocacy

 

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