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American Dental Education Association
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Volume 1, No. 45, January 24, 2020
U.S. House of Representatives Approves VA Dental Care Pilot Program
Last week, the U.S. House of Representatives passed H.J. Res 80 [ [link removed] ] , which authorized the U.S. Department of Veterans Affairs (VA) to establish a pilot program connecting eligible veterans with dental care services from community providers. The resolution must now be approved by the Senate.
It should be stressed that this is a pilot program and, as such, it will be limited to certain areas for a five-year period. The specific areas and the dates of the pilot program will likely be decided later in the year.
Currently, the VA can only provide dental services to veterans who have a service-connected dental problem or who meet certain other criteria. As a result, the VA currently provides dental services annually to only 8% of the veterans enrolled in the VA’s health care system.
This resolution was in response to a VA request to Congress [ [link removed] ] , asking for a waiver to develop a program to serve as a new service delivery model for veterans. Under the pilot program, the VA would provide eligible veterans information about dental care offered by local providers as well as work with external entities to connect the veterans with community-based, pro bono or discounted dental services. The VA would not cover the cost of external dental services under the pilot program; the Department would simply act as an intermediary connecting the veteran with local dental service providers. Under current law, the VA cannot connect veterans with external dental providers.
Veteran organizations are not happy with the proposed pilot program because it relies on non-governmental funding, rather than relying on the VA to cover dental services for all veterans enrolled in the VA health care system—not just the 8% of veterans who qualify for VA dental services.
Indiana Bill Would Expand Permitted Practices for Allied Professionals
A bill that recently passed the Indiana House of Representatives would allow dental hygienists to administer local dental anesthetics without supervision and would allow dental assistants and dental hygienists to administer nitrous oxide under the direct supervision of a dentist, if the dental hygienist or dental assistant meets qualifications established by the bill. To be permitted to administer nitrous oxide, dental assistants and dental hygienists would be required to:
• Graduate from a program accredited by the Commission on Dental Accreditation (CODA),
• Be employed in a dental setting for at least one year,
• Complete a three-hour course accredited by CODA that covers specified topics and
• Demonstrate clinical competency on at least five patients under the direct supervision of a licensed dentist.
The bill passed the House on Jan. 14 and was referred to the Senate for consideration on Jan. 15.
North Carolina Rule Change Allows Public Health Dental Hygienists to Perform More Procedures
A recently approved rule [ [link removed] ] in North Carolina would allow public health dental hygienists to perform preventive procedures under general supervision. Under the rule, public health dental hygienists would be permitted to perform [ [link removed] ] cleanings, apply sealants, provide fluoride treatments and deliver other preventive services under a written standing order from a dentist. Services provided under the rule would be limited to public health-specified settings, such as schools, nursing homes and rural and community clinics.
The rule was approved by the State Board of Dental Examiners in December 2019 and by the Rules Review Commission on Jan. 16. The rule will become effective on Feb. 1, if the Rules Review Commission does not receive 10 or more [ [link removed] ] written objections to the rule.
Virginia Bill Would Expand People Permitted to Apply a Fluoride Varnish
A bill [ [link removed] ] moving through the Virginia General Assembly would expand the number of people permitted to apply a fluoride varnish under a standing order. The bill would allow anyone permitted to administer medication pursuant to a standing order issued by a dentist, M.D. or D.O. to apply a fluoride varnish. The bill passed the state Senate on Jan. 14 , and will now be sent to the House for consideration.
ACA Remains Stable Despite Removal of Individual Mandate Penalty
The Kaiser Family Foundation released an article [ [link removed] ] on Jan. 14 highlighting the continued stability of the Affordable Care Act (ACA) without the individual mandate penalty. Under the individual mandate, individuals were required to purchase health insurance that satisfies minimally acceptable coverage requirements. Those individuals who did not purchase the appropriate health insurance had to pay a tax penalty, also known as the individual mandate penalty. However, this tax penalty was eliminated in the 2017 by the Trump Administration.
As the article notes, the elimination of the individual mandate penalty did not cause the exchange marketplaces to fall into a "death spiral" because healthy enrollees have not left the exchange marketplace, nor has Medicaid expansion been impacted by the disappearance of the penalty. In fact, participating marketplace insurers remain financially stable, despite earlier loses during the initial rollout of ACA.
However, the exchange marketplaces are not perfect and continue to be plagued by issues of unaffordability for those who do not qualify for subsidies. Also, finding coverage in certain areas—particularly in rural areas—remains a challenge.
Evidence pointing to the stability of the ACA exchange marketplace despite the elimination of the individual mandate penalty strikes at the heart of a key argument in Texas v. Azar case. In that case, the plaintiff’s argument that the ACA is not legally or commercially viable without the individual penalty mandate runs contrary to evidence like this suggesting otherwise.
Attention, dental and craniofacial researchers, oral health advocates, dental educators, students, residents and fellows:
Join the American Association for Dental Research (AADR), the American Dental Education Association (ADEA) and the Friends of National Institute of Dental and Craniofacial Research (FNIDCR) on Tuesday, March 17, 2020, for the 2020 AADR, ADEA and FNIDCR Capitol Hill Day. For Capitol Hill Day registration and information, 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.
©2020
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
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