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American Dental Education Association
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Volume 1, No. 43, December 20, 2019

House Democrats Pass Bill to Lower Prescription Drug Costs
 
On Dec. 12, the House passed H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act, fulfilling a campaign promise to lower prescription drugs [ [link removed] ] . The bill would enable the U.S. Department of Health and Human Services (HHS) to negotiate prices for 250 of the most used drugs, including insulin, for Medicare program beneficiaries. Drug manufacturers would also be required to offer the prices negotiated by HHS for the Medicare program to private insurers as well. Additionally, drug manufacturers would also pay rebates to Medicare if the price of their drugs outpaced the rate of inflation. Requiring drug manufacturers to extend negotiated prices to the private market extends the impact of H.R. 3 beyond the confines of the Medicare program.
 
Both drug manufacturers and Republicans opposed the bill, asserting that it would limit research and development and therefore, negatively impact patients’ ability to access life-saving drugs. Democrats countered that argument by putting an additional $10 billion in the National Institutes of Health’s budget. This money would be used for biomedical research focused on developing breakthrough cures. H.R. 3 passed mostly along a party line vote of 230-192. While it is unlikely the U.S. Senate will take up the bill, President Donald Trump has already said he would veto the bill.

Licensure Portability May Be Coming to Ohio
 
Licensure portability may be coming to Ohio as two bills in the legislature would create significant changes for licensed professionals, including dentists, dental hygienists and dental assistants.
 
S.B. 7 [ [link removed] ] would increase portability for members of the military and their spouses by requiring state occupational licensing agencies to issue temporary licenses or certificates to members of the military and their spouses if they are licensed in another jurisdiction and are on military duty in Ohio. This bill is on the verge of becoming law as it has passed both chambers of the legislature and is now headed to the desk of Gov. Mike DeWine (R).
 
Another recently filed bill [ [link removed] ] , H.B. 432, modeled after licensure reform laws in Arizona and Pennsylvania [ [link removed] ] , would implement broader licensure reciprocity changes for many licensed professionals who are not members of the military or a military spouse. The bill includes several specific changes for the Ohio State Dental Board, including a requirement for the Board to grant a license to any applicant who holds a license to practice dentistry or dental hygiene in another state. The bill also allows the Board to issue a teaching license to a dentist licensed in another state. The bill also requires the following:
 • The Board must issue a permit to employ or use conscious sedation to a dentist licensed in another state if the dentist holds a license to employ or use conscious sedation in another state or, if coming from a state that does not issue a license or certificate, the dentist has completed satisfactory work experience, holds a government certification or private certification.
 • The Board must issue a general anesthesia permit to a dentist licensed in another state when the dentist holds a general anesthesia license or permit in another state or, if coming from a state that does not issue a license or certificate, has completed satisfactory work experience, holds a government certification or private certification.
 • The Board must issue a certificate to a dental assistant to engage in polishing activities when an applicant holds a license or certificate in another state or, if coming from a state that does not issue a license or certificate, has completed satisfactory work experience, holds a government certification or private certification.
 • The Board must issue a certificate to a dental rediograph machine operator when an applicant holds a license or certificate in another state or, if coming from a state that does not issue a license or certificate, has completed satisfactory work experience, holds a government certification or private certification.
 • The Board must issue a license to an expanded function dental auxiliary who is licensed or registered in another state or, if coming from a state that does not issue a license or certificate, has completed satisfactory work experience, holds a government certification or private certification.

The bill also addresses out of state practitioners who wish to engage in teledentistry in Ohio by including a clarifying provision that states dentists who hold a license in another state must obtain a teledentistry permit, but do not need to obtain an Ohio license.

Congress Poised to Enact FY 2020 Appropriations Bills
 
The U.S. House of Representatives and U.S. Senate negotiators have reached agreement on all 12 appropriations bills. The bills will be separated into two bills, one containing security agencies and the other containing everything else.
 
The Labor, Health and Human Services, Education and Related Agencies bill contained good news for programs important to dental education. The National Institute for Dental and Craniofacial Research will receive $477.4 million—a $15.7-million increase over the previous fiscal year. The Oral Health Training Program, which provides grants to dental schools for pre- and postdoctoral education and training for students from underserved populations, will receive $40.7 million. This includes $12 million each for Pediatric and General Dentistry Residencies and for the Dental Faculty Loan Repayment Program for all dental professionals. Also, of interest is a slight increase for the Health Careers Opportunity Program to $15 million. This is a pipeline program that provides grants to health professions schools to develop and implement programs to provide individuals from disadvantaged backgrounds an opportunity to learn about various health professions careers.
 
The House passed the bill by a wide bipartisan margin on Dec. 17 and the Senate followed suit on Dec. 19. The White House has not said officially that President Trump will sign the bills, but individuals there have said that they expect him to sign the legislation before the current continuing resolution expires at midnight on Dec. 20.

Virginia Medicaid Recipients Turn to the ER for Dental Care
 
A new report [ [link removed] ] from the Virginia Department of Medical Assistance Services found that more than half of the 16,000 Medicaid recipients who visited the emergency room in the state this year did so for non-traumatic, dental conditions that could have been prevented or treated in a dentist’s office. While all states and territories must provide dental coverage for recipients under the age of 21 to meet Early Periodic, Screening, Diagnostic and Treatment [ [link removed] ] requirements, dental coverage for adult Medicaid recipients is optional for states. As a result, dental coverage for adults varies state by state [ [link removed] ] , and Virginia limits coverage [ [link removed] ] to “medically necessary oral surgery and associated diagnostic services, such as [radiographs] and surgical extractions.”
 
Virginia Medicaid does provide more extensive dental coverage for pregnant and postpartum women [ [link removed](11.01.2018).pdf ] , up to 60 days after giving birth. That coverage may soon be extended [ [link removed] ] as Gov. Ralph Northam (D) recently unveiled a plan intended to reduce disparities in maternal mortality, which includes extending Medicaid coverage for postpartum women up to one year after giving birth.
 
At least two states—Delaware [ [link removed] ] and Utah [ [link removed] ] —added or expanded dental coverage for adult Medicaid recipients or specific groups of adult Medicaid recipients during the most recent legislative session, while a handful of states passed legislation to take steps toward implementing coverage. Only 19 states [ [link removed] ] and Washington, DC currently offer extensive dental coverage for adult Medicaid recipients.

House Passes Bill to Permanently Fund HBCUs and Minority-serving Institutions
 
On Dec. 10, the U.S. House of Representatives passed [ [link removed] ] an amended version of the FUTURE Act (H.R. 2486 [ [link removed] ] ), which was originally passed by the House in September. However, the bill was unable to secure enough votes in its original form to pass out of the Senate. A bipartisan compromise was reached, whereby the key provision of the FUTURE Act, namely a permanent $255-million funding stream for historically black colleges and universities (HCBU) and other minority-serving institutions (MSI), was paired with provisions streamlining the FAFSA and other financial aid and student loan repayment processes. The White House supports the bill and is expected to sign it into law.

Circuit Court Rules Obamacare’s Individual Mandate Unconstitutional
 
On Dec. 18, the 5th Circuit Court of Appeals upheld [ [link removed] ] a lower court’s decision invalidating the Affordable Care Act’s (ACA) individual mandate, but the Court did not address the issue of whether ACA itself remained viable without the individual mandate.
 
Stating that “the rule of law demands a careful, precise explanation of whether the provisions of the ACA are affected by the unconstitutionality of the individual mandate as it exists today,” the three-judge panel of the Appeals Court returned the case to the U.S. District Court for the Northern District of Texas, leaving the lower court to decide if ACA can survive without the individual mandate.
 
Because the case was returned to the lower court, the District Court will likely go through a lengthy trial process again, making it unlikely that a decision regarding whether ACA will be struck down, in whole or in part, prior to the 2020 presidential election. Millions of Americans, including employers and those with pre-existing conditions, will remain in limbo as to whether their health coverage will continue due to the uncertainty surrounding the case. The 5th Circuit’s decision also ensures that health care will again be one of the issues at the forefront of the 2020 election.
 
The Trump administration had previously said it would not move to immediately enforce any decision the 5th Circuit Court of Appeals. Currently, ACA remains the law of the land. The essential health insurance benefits that it requires, as well as the protections extended to those with pre-existing conditions, remain in effect.

The next issue of the ADEA Advocate will be published on January 14, 2020. Thank you for reading and we will see you in the New Year.

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

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