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American Dental Education Association

Volume 2, No. 24, September 22, 2021

House Ways & Means Committee Bill Provides a Dental and Oral Health Services Benefit in Medicare
 
In the Sept. 14 edition of the ADEA Advocate [ [link removed] ] , we mentioned that the U.S. House of Representatives’ Committee on Ways and Means marked up legislation that would add a dental and oral health services benefit [ [link removed] ] to Part B in Medicare. The benefit would begin on Jan. 1, 2028, to allow time to develop the mechanisms and infrastructure to implement this change. There are more details regarding the dental and oral health services benefit:
 • Those who can be reimbursed for care are oral health professionals. An “oral health professional” is defined as a D.D.S., D.M.D. or other allied professional licensed and acting within the scope of that license by a state in which the services are furnished.
 • The services include:
    ◦ Preventive and screening services, such as oral exams, dental cleanings, dental X-rays performed in the office and fluoride treatments;
    ◦  Basic treatments, such as basic tooth restorations, basic periodontal services, tooth extractions and oral disease management services; and
    ◦ Major treatments, such as major tooth restorations, major periodontal services, bridges, crowns and root canals.

 • The bill also includes dental benefits for dentures, pursuant to a written doctor’s order, not more often than every five years unless “a doctor” determines that the dentures do not fit the individual. The bill requires that the dentures be acquired by competitive bid. It appears that there is an exception if the dentures are furnished by the practitioner to her or his own patients.
 • Under the bill, oral exams and dental cleanings are limited to twice a year. Other services (those previously mentioned and those not listed) may be limited in frequency or such circumstances as the Secretary of Health and Human Services may determine.
 • Under the bill, the Secretary may make payments for dentures and other services as bundled payments as they determine.
 • The bill states that the benefit payment amount shall be the applicable percent of the lesser of the actual charge or an amount determined by the Secretary for a service under a fee schedule. The applicable percent for preventive and screening services or basic services is 80%. The applicable percent for major treatments will be phased in annually:
    ◦ 10% in 2028,
    ◦ 20% in 2029,
    ◦ 30% in 2030,
    ◦ 40% in 2031 and
    ◦ 50% in 2032 and beyond.


This phase-in period is designed to push the costs beyond the Congressional Budget Office’s 10-year scoring window (2022-2032) for the bill.

California Sends Multiple Bills Impacting Oral Health Professionals to Governor
 
The California Legislature entered an interim recess last week and is unlikely to meet again before 2022. Before wrapping up business for the year, legislators sent multiple bills to Gov. Gavin Newsom (D) that could impact oral health professionals. Summaries of those bills are below:
 • AB 107 [ [link removed] ] expands a requirement to issue temporary licenses by credentials to spouses and domestic partners of active-duty members of the military who are assigned to a duty station in California under official active-duty military orders. Current law places this requirement on some boards that are under the jurisdiction of the state’s Department of Consumer Affairs. This bill would expand this requirement to all boards under the jurisdiction of the Department, including the Dental Board of California.
 • AB 526 [ [link removed] ] authorizes a dentist or podiatrist, if the dentist or podiatrist complies with specified requirements, to independently prescribe and administer for persons three years of age or older influenza and COVID-19 vaccines approved or authorized by the U.S. Food and Drug Administration. The bill also expands the definition of “laboratory director” to include a duly licensed dentist serving as the director of a laboratory that performs only authorized clinical laboratory tests.
 • AB 615 [ [link removed] ] requires a higher education employer to provide a procedure for all medical and dental interns and residents to challenge a termination of employment or a disciplinary action after the employee has exhausted available administrative or academic grievance processes, as provided. The bill would not apply to a termination of employment or disciplinary action based on certain academic or clinical matters. A similar bill passed the legislature in 2020, but it was vetoed [ [link removed] ] by the Governor.
 • SB 242 [ [link removed] ] requires health insurers and health care service plans, including plans that offer a contract covering dental services, to reimburse contracting health care providers for business expenses undertaken to prevent the spread of respiratory-transmitted infectious diseases causing public health emergencies that were declared on or after Jan. 1, 2022. “Business expenses” are defined as personal protective equipment, additional supplies, materials and clinical staff time over and above those expenses usually included in an office visit or other non-facility service or services.
 • SB 365 [ [link removed] ] makes electronic consultation services reimbursable under the Medi-Cal program for enrolled providers, including federally qualified health centers or rural health clinics. The bill sets the condition of its implementation on the reimbursement of the state’s Department of Health Care Services obtaining necessary approval of federal matching funds.
 • SB 534 [ [link removed] ] makes numerous changes to provisions of law that govern mobile dental hygiene clinics and special teaching permits for dental hygienists licensed in other states. An extensive summary of this bill was provided in the May 18 edition of the ADEA Advocate [ [link removed] ] . The May 18 summary includes a description of provisions that would have created changes to the membership of the dental hygiene board, which were struck from the final version of the bill.
 • CA SB 607 [ [link removed] ] made several changes to licensing laws in the state. The changes include the following:
    ◦ The bill deletes provisions of the current law that required registered expanded functions dental assistants to pass a clinical or practical examination requirement for licensure.
    ◦ It limits the application fee for a pediatric minimal sedation permit to $1,000 and the renewal fee to $600.
    ◦ The bill clarifies that a foreign dental school whose program approval was renewed by the Dental Board of California prior to Jan. 1, 2020, through any date between Jan. 1, 2024, and June 30, 2026, will maintain approval through that date. Upon expiration of the approval, the foreign dental school will be required to comply with legislation that was passed in 2019 [ [link removed] ] , which requires foreign dental schools to complete the international consultative and accreditation process with the Commission on Dental Accreditation or a comparable accrediting body approved by the Board.
    ◦ It extends the repeal date of the Dental Hygiene Board of California and related appointment provisions from Jan. 1, 2023, to Jan. 1, 2024.

 • SB 682 [ [link removed] ] establishes the End Racial Inequities in Children’s Health in California Initiative (EnRICH CA Initiative). The bill requires the California Health and Human Services Agency, in collaboration with other specified groups, to convene an advisory workgroup to develop and implement a plan that establishes targets to reduce racial disparities in health outcomes by at least 50% by Dec. 31, 2030, in chronic conditions affecting children. These chronic conditions include but are not limited to asthma, diabetes, dental caries, depression and vaping-related diseases. The agency would be required to submit the plan for the EnRICH CA Initiative to the legislature and post the plan online by Jan. 1, 2023, and to commence implementation of the plan no later than June 30, 2023.

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
 • Provider Relief Fund Reporting portal [ [link removed] ]
 • ADEA memo [ [link removed] ] regarding vaccines at the state level
 • 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] ] .

ADEA State Calendar [ [link removed] ]

ADEA Washington Calendar [ [link removed] ]

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.
 
©2021
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 and Advocacy
 
Phillip Mauller, M.P.S.
ADEA Director of State Relations and Advocacy
 
Brian Robinson
ADEA Program Manager for Advocacy and Government Relations
 
[email protected] [ [link removed] ]

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