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Federal Issues Summary - 2013-2014

Prevention of Essential Drug Shortages

The number of vital drugs in critically short supply has been increasing notably. Health care providers, including OMSs, are among the last to know when an essential drug will no longer be available. This is especially troublesome when it comes to sedation and anesthesia drugs like Propofol and Fentanyl.

AAOMS ACTION:

  1. AAOMS submitted a response to an FDA request for comments on the drug shortage issue for consideration by the Drug Shortages Task Force strategic plan created following a 2012 law. Responses covered questions from how FDA communication tools should be more effectively used to help health care professionals, manufacturers, distributors, patients, and others manage shortages, to what incentives other agencies can provide, separately or in partnership with FDA, to prevent shortages.
Federal Health Reform Efforts and the Health Reform Law, The Affordable Care Act (ACA)

The ACA was signed into law on March 23, 2010 and represents the most significant regulatory overhaul of the US healthcare system since the passage of Medicare and Medicaid. This law will impact the way in which OMSs practice in numerous ways. While the law was upheld by the Supreme Court in June 2012, AAOMS continues to remain active on efforts to influence/amend specific provisions of the law through the legislative/regulatory process.

HEALTH INSURANCE EXCHANGES

The ACA creates insurance exchanges run by the state or federal government where consumers who do not have employer-sponsored coverage are required to purchase insurance to qualify for gov’t subsidies.

AAOMS ACTION:

  1. Developed a resource document for membership on key information about the Exchanges that they might be interested in as an individual or an employer.
REPEAL OF THE MEDICAL DEVICE EXCISE TAX

The ACA includes a provision that requires a 2.3% excise tax on medical devices that is collected at the point of sale. This tax will very likely apply to many of the devices used by OMSs.

AAOMS ACTION:

  1. Sent letters to Rep. Erik Paulsen (R-MN) and Sen. Orrin Hatch (R-UT) expressing support for their legislation (HR 523, S 232) to repeal the device tax.
  2. Signed onto a coalition letter sent to Congress requesting that repeal of the medical device tax be addressed as a top legislative priority.
  3. AAOMS maintains an active grassroots congressional letter-writing campaign on the issue.
  4. AAOMS members advocated for this issue as an AAOMS priority at the 2013 Day on the Hill.
REPEAL OF THE MEDICARE INDEPENDENT PAYMENT ADVISORY BOARD (IPAB)

The 15-member IPAB, which was conceived as a cost control mechanism for the Medicare program and created under the ACA, does not adequately understand the needs of providers and their patients. It holds a great deal of power over Medicare and health care decisions, yet is completely unaccountable to the public.

AAOMS ACTION:

  1. Signed onto a coalition letter sent to Congress expressing deep concern about the impact the IPAB will have on patient access to quality healthcare and its precedent for overriding the normal legislative process.
  2. Sent letters to Rep. David Roe (R-TN) and Sen. John Cornyn (R-TX) expressing support for their legislation (HR 351/S 351) to repeal the IPAB.
  3. AAOMS maintains an active grassroots congressional letter-writing campaign on the issue.
  4. AAOMS members advocated for this issue as an AAOMS priority at the 2013 Day on the Hill.
FLEXIBLE SPENDING ACCOUNTS

The ACA imposed a restriction on employee contributions to FSAs to $2,500 per year.

AAOMS ACTION:

  1. Sent letters to Rep. Erik Paulsen (R-MN) and Sen. Mike Johanns (R-NE) expressing support for their Legislation (HR 1248/S 610) to repeal the provision of the ACA that imposes a $2,500 limitation on contributions to health flexible spending arrangements.
  2. AAOMS members advocated for this issue as a secondary AAOMS priority at the 2013 Day on the Hill.
Prescription Drug Use

The abuse of prescription drugs, especially opioids, has been a growing concern among federal lawmakers and stakeholders. Since the start of 2013, seven pieces of legislation have been introduced to stem this “epidemic.” Many of these bills would directly impact the way in which OMSs train, practice, and prescribe and suggest some sort of mandatory continuing education requirements for prescribers.

AAOMS ACTION:

  1. oined an Organized Dentistry Coalition (ODC) comment letter that expressed support for the Access to Substance Abuse Treatment Act (HR 2130), which would amongst other things, recognize dental care as a covered wrap-around service for the treatment of those with substance use disorders and would support education and training for oral health professionals to learn more about substance use disorders and their relationship to oral health and dental care.
  2. AAOMS President, Miro A. Pavelka, DDS, MSD, testified at a Feb. 2013 hearing before the US Food and Drug Administration (FDA) regarding the experiences of OMS members in providing pain management to patients. AAOMS sent a separate follow up comment letter to the FDA regarding the pain management education AAOMS members are receiving and AAOMS efforts to track the outcomes of such education on OMS prescribing habits.
Antitrust Reform

The “Competitive Health Insurance Reform Act” would amend the McCarran-Ferguson Act to revoke the federal antitrust exemption for health insurance companies. This would help to prohibit unfair competitive business practices in the health insurance industry.

AAOMS ACTION:

  1. Sent a letter to Congressman and dentist Paul Gosar (R-AZ) expressing support for his legislation (HR 911) to repeal the McCarran-Ferguson Act’s exemption of health insurance companies from federal antitrust
  2. AAOMS advocated in support of antitrust reform at the 2013 Day on the Hill.
  3. AAOMS maintains an active grassroots congressional letter-writing campaign on the antitrust reform issue.
ERISA Reform

Some dental benefit plans employ unfair practices that hinder patients' ability to receive the full benefits for which they pay. The “Dental Insurance Fairness Act” would improve value and transparency in health coverage by applying uniform benefits requirements to self-insured group health plans that provide dental benefits.

AAOMS ACTION:

  1. Sent a letter to Congressman and dentist Paul Gosar (R-AZ) expressing support for his legislation (HR 1798) to apply uniform coordination and assignment of benefits requirements to self-insured group health plans that provide dental benefits.
Medicare Physician Reimbursement

Medicare physician reimbursement is currently determined by a flawed formula that would consistently cut reimbursement year after year without Congressional intervention. Third party payers often follow the trends of Medicare payment policy.

AAOMS ACTION:

  1. Sent a comment letter to key committee leaders in the House offering suggestions on a new framework for repealing the current reimbursement formula and developing new payment methodologies.
  2. Sent a comment letter to the Senate Finance Committee in response to their request for stakeholder input on Medicare payment reform.