Legislative updates from the American Student Dental Association

August 2013


From Washington

Bipartisan Student Loan Certainty Act passes Congress, awaits President's signature
Last night, the U.S. House of Representatives voted 392-31 to approve legislation that would lower the interest rate on federally-backed Stafford Loans. This ended a month-long battle, as the interest rate doubled for undergraduate subsidized Stafford Loans from 3.4 percent to 6.8 percent on July 1. According to Congress' Joint Economic Committee, this interest hike resulted in a $2,600 increase for the average student.
 
After the Bipartisan Student Loan Certainty Act (H.R. 1911/S. 1334) passed the Senate last week, ASDA members responded by sending nearly 900 letters to their Congresspersons, urging them to protect access to affordable loans. This was ASDA's first letter-writing campaign using ASDA Engage.
 
The ratified bill would tie student loan interest rates to the 10-year Treasury note and includes a 2.05 percent administration fee, currently resulting in a 3.8% rate for new undergrad loans made this fall. The Stafford Loan interest rate structures are as follows:
  • Unsubsidized Undergrad Stafford: Current Treasury note (1.81) + 2.05 = 3.86% (capped at 8.25%)
  • Unsubsidized Graduate Stafford: Current Treasury note (1.81) + 3.6 = 5.41% (capped at 9.5%)
  • PLUS Loans: Current Treasury note (1.81) + 4.6 = 6.41% (capped at 10.5%)

The Congressional Budget Office estimates this proposal will provide a savings of $715 million over the next 10 years. President Obama has voiced his support for tying the Stafford interest rate to the Treasury note and is expected to sign Bipartisan Student Loan Certainty Act.

 

Read more about student debt.

Senate Finance Committee issues report on corporate dental practices

In June, the Senate Finance Committee released the "Joint Staff Report on the Corporate Practice of Dentistry in the Medicaid Program" and called on the Department of Health and Human Services (HHS) to disqualify dental clinics from Medicaid if such clinics elude state laws intended to safeguard against non-dentists providing treatment. According to the report, while many clinics meet the minimum state regulations (including requiring the clinics to be owned by licensed dentists), some are operated by corporate investors, thus jeopardizing patient safety and care. Currently 22 states and District of Columbia prohibit corporate dental practices.

 

The Committee reported a failure to meet quality and compliance standards, including unnecessary treatment on children; improper administration of anesthesia; providing care without proper consent; and overcharging the Medicaid program. Due to these findings, Committee Chairman Max Baucus (D-Mont.) and Senator Chuck Grassley (R-Iowa) are urging HHS to discontinue taxpayer reimbursement of such culpable entities.

 

The report recommends Medicaid be allowed to reimburse midlevel dental providers, such as dental therapists. ASDA endorses expanded functions for dental auxiliaries only when each has received the appropriate education and training to guarantee competence, and when such functions fall within the laws established by their respective state of employment.

Read more about midlevel providers.

From the States 

WSDA anticipates a strong dental workforce  

The Washington State Dental Association (WSDA) released their 2012 Dental Workforce Report in June, which comprehensively details an optimistic projection of the future workforce. The study's key finding reports that the state will continue to experience a strong ratio of dentists to population. Washington's current ratio is 71 dentists for every 100,000 patients-one of the 10 best ratios in the nation. The projected number of dentists relative to the population will continue to increase over the next few years, and then return to the ratio seen in Washington in the late 1990s and early 2000s: 66 dentists per 100,000 Washingtonians by 2032.  

 

Read the full report.

Wisconsin Governor approves NCS legislation

In early July, Wisconsin Governor Scott Walker signed A.B. 109, known in organized dentistry as Wisconsin's version of the non-covered services (NCS) act. This legislation, supported by the Wisconsin Dental Association (WDA), prevents insurance providers from setting fees for dental services they offer without proper reimbursement to the dental professional. This legislation was a cornerstone of WDA's state lobby day agenda, where 160 Marquette ASDA members lobbied in support of the measure. A.B. 109 ultimately gained significant bipartisan support, as 90 co-sponsors joined in the effort to bring further transparency in the cost of oral health care. Similar NCS regulations exist in nearly 30 states.

 

Read more about non-covered services.  

State policy updates

The Arizona state legislature passed H.B. 2010 to expand Medicaid under the Affordable Care Act. Arizona Governor Brewer signed the bill on June 17. Toward the end of the regular legislative session, Gov. Brewer began vetoing legislation, making good on a promise to refuse to sign additional measures into law until the Arizona Legislature passed a 2014 budget and a Medicaid expansion bill. However, an opposition group, led by former state Senators Frank Antenori and Ron Gould, has until Sept. 11 to gather 86,405 valid signatures to put the measure to a vote. If they succeed, Medicaid expansion will be blocked until the November 2014 general election.

 

 

Colorado Governor John Hickenlooper signed into law H.B. 1320, creating a new class of merit scholarship for Colorado residents who achieve certain criteria, such as a high grade point average or a high-class rank. The bill allows state-supported institutions of higher education that enroll Colorado Scholars to count each of them as two in-state students when calculating the ratio of in-state to out-of-state students, thus effectively giving institutions a way to enroll a larger proportion of out-of-state students without violating the statutorily mandated cap on non-resident students. Under existing law, 55 percent of incoming freshmen enrolling at state institutions of higher education, and not less than two-thirds of total student enrollment, must be resident students. Some argue that the law allows Colorado colleges and universities to generate more in tuition revenue at a time when state support for higher education has decreased.

 

 

Maine L.D. 1230, sponsored by Speaker of the House Mark Eves and co-sponsored by more than 40 members of the House of Representatives and the Senate, would have established the role of dental hygiene therapist, but failed to pass the Senate. On June 18, the House adopted the bill with amendments by a vote of 95-45; however, the Senate rejected the bill 21-14 the following day. ASDA worked with others in organized dentistry to actively oppose the legislation.

 

 

Texas Governor Rick Perry signed into law S.B. 8 on June 14. The law requires the Executive Commissioner of the Health and Human Services Commission (HHSC or commission) to establish a data analysis unit within the commission to improve contract management, detect data trends, and identify anomalies in the provision of Medicaid and Children's Health Insurance Program (CHIP) services and contracts. The law establishes rules prohibiting certain unsolicited personal contact through direct marketing by providers participating in Medicaid or CHIP. The law authorizes HHSC to review and provide authorization of provider-proposed marketing activities and adopt rules that exempt certain marketing activities from the prohibition. The law also requires HHSC to enter into a memorandum of understanding with the Texas Department of Motor Vehicles and the Texas Department of Public Safety to obtain motor vehicle and driver's license information of a provider of medical transportation services. Additionally, under the new law, HHSC is required to review the prior authorization and utilization review processes within the fee for service delivery model and to monitor Medicaid managed care organizations to ensure that the organizations are using prior authorization and utilization review processes.

 

Source: July ADEA State Update

Contact:
Andrew Smith, governance and advocacy manager
ASmith@ASDAnet.org | 312-440-2795
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