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American Dental Education Association
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Volume 1, No. 36, October 29, 2019
House Extends Medicare Coverage to Include Dental Coverage
U.S. Rep. Robin Kelly's (D-IL) Medicare Dental Coverage Bill of 2019, H.R. 4650 [ [link removed] ] , which would extend dental coverage to Medicare beneficiaries, passed out of the U.S. House of Representatives’ Ways and Means Committee along with H.R. 3 [ [link removed] ] , the Lower Drug Costs Now Act of 2019. Two additional Medicare-related bills also passed out of the Committee, H.R. 4665 and H.R. 4618. H.R. 4665 extends vision coverage to Medicare beneficiaries, while H.R. 4618 extends hearing coverage for beneficiaries, specifically including the coverage of the cost of hearing aids.
H.R. 3 would empower the federal government to directly negotiate certain drug prices for Medicare recipients and, in doing so, mark a major shift in the way drug prices are set in the United States as well as increasing access to medication. The U.S. Congressional Budget Office estimates that this bill will produce $345 billion in cost savings. The Democrats intend to use the cost savings to pay for the expansion of Medicare coverage to include dental, vision and hearing.
H.R. 3 passed out of the House Ways and Means Committee along a party line vote. Though the Democrats had initially planned to bring H.R. 3 and the three associated bills to the House floor for a vote by the end of October, it was announced at the end of last week that these bills will not be voted on by the House until mid-November.
However, H.R. 3 has little chance of passage in the U.S. Senate because Senate Republicans do not support the bill, which means expanding Medicare coverage to include dental is not likely to happen this year.
HHS Issues Guidance on Reducing Long-term Opioid Use Without Harming Patients in Chronic Pain
The U.S. Department of Health and Human Services (HHS) has issued guidance on managing patients with pain who are on opioids but are not addicted to them. The guidance, HHS Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics [ [link removed] ] , emphasizes patient-centered care and recommends against a rapid taper or stopping opioids all at once.
Besides outlining the risks of a rapid taper, the document discusses when to consider tapering, considerations before deciding to taper and actions to take before tapering. Other topics discussed include:
• Individualizing the rate of tapering,
• Diagnosing for opioid-use disorder, if necessary,
• Treating withdrawal symptoms,
• Approving behavioral health support and
• Other issues.
More importantly, the guidance emphasizes that the Centers for Disease Control and Prevention guidelines do not recommend opioid discontinuation when benefits of opioids outweigh risks. It also warned against interpreting dosage thresholds in the 2016 document as mandatory upper limits.
The guidance was issued in response to complaints and concerns raised by patients living with chronic pain and their doctors. These patients reported they were being denied medication that allowed them to function, though they were not addicted to the medication. Doctors have also described battles to secure pain medication for patients with cancer and other painful diseases, such as sickle cell anemia.
Court Cases Lead to Suspension of Arizona Medicaid Work Requirement
State officials in Arizona [ [link removed] ] have decided to suspend implementation of the state’s Medicaid work requirement. According to an Oct. 17 letter [ [link removed] ] sent to the Centers for Medicare and Medicaid Services, the state is choosing to suspend implementation because of “the evolving national landscape concerning Medicaid community engagement programs and ongoing litigation regarding the topic.”
Readers of the ADEA Advocate may recall that a federal judge overturned similar work requirements in Arkansas, Kentucky and New Hampshire, and that another lawsuit is challenging work requirements in Indiana. An appeals court is reviewing the rulings in Arkansas, Kentucky and New Hampshire, but according to some experts, the court has hinted [ [link removed] ] that it will likely uphold the ruling.
Medicaid/CHIP Enrollment Down by More than One Million Children
A recent analysis conducted by the New York Times [ [link removed] ] found that national child enrollment in Medicaid and the Children’s Health Insurance Program (CHIP) dropped by more than one million children between December 2017 and June 2019. While some state officials have asserted that the reduction in enrollment is the result of a growing economy that has led to increased coverage from employers, data and anecdotal evidence presented by the Times suggest that other factors may also be driving lower rates of enrollment.
Between 2016 and 2018, the number of children lacking any kind of health coverage increased by 400,000. Some of the states that experienced the largest increase in uninsured children also created new rules that increased paperwork required to confirm eligibility, or implemented new computer systems used to list enrollees. In some states with large immigrant populations, the proposed public charge [ [link removed] ] rule is causing some immigrant families to avoid enrolling their children, over fears that they may be penalized for using public benefits.
Under federal law, all states are required to provide dental benefits [ [link removed] ] for children enrolled in Medicaid or CHIP.
ADEA State Calendar [ [link removed] ]
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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.
©2019
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:
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