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Federal Issues Summary - 2015-2016

FEDERAL HEALTH REFORM EFFORTS (THE AFFORDABLE CARE ACT)

The ACA was signed into law on March 23, 2010. While the law was upheld by the Supreme Court in June 2012, AAOMS continues to remain active on efforts to influence/amend through the legislative/regulatory process specific provisions of the law that impact OMS practices.

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 applies to many of the devices used by OMSs.

AAOMS ACTION:

  1. Sent letters in 2015 to Rep. Erik Paulsen (R-MN) and Sen. Orrin Hatch (R-UT) expressing support for their legislation (HR 160, S 149) to repeal the device tax.
  2. Advocated for this issue as an AAOMS priority at the 2015 Day on the Hill.
  3. AAOMS maintains an active grassroots congressional letter-writing campaign on the issue.

Success!
A 2-year moratorium on the tax was enacted in Dec. 2015. AAOMS continues to advocates for a full repeal.

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. Joined a 2015 coalition comment letter that expressed support for repeal of the IPAB.
  2. Advocated for this issue as a secondary priority at the 2015 and 2016 Days on the Hill.
  3. AAOMS maintains an active grassroots congressional letter-writing campaign on the issue.

Success!
The IPAB has not been funded or implemented since the ACA was enacted. AAOMS continues to advocates for a full repeal.

Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs)

The ACA imposed several restrictions on employee contributions to FSAs and HSAs.

AAOMS ACTION:

  1. Sent a letter to Rep. Steve Stivers (R-OH) expressing support for his legislation, the RAISE Health Benefits Act (HR 1185) to (1) cancel the FSA “use-it-or-lose-it” rule (2) increase the annual FSA contribution limit to $5,000 and (3) allow families with more than two dependents to deposit up to $500 a year to their FSA for each additional dependent.
  2. Sent a letter to Rep. Michael Burgess (R-TX) expressing support for his legislation (HR 1196) to (1) double the annual HSA contribution limit to $6,600 per year for individuals and $13,200 per year for families and (2) expand HSA availability beyond just those with high deductible plans.
  3. Joined an Organized Dentistry Coalition (ODC) comment letter that expressed support for HR 1185.
  4. Organized an ODC coalition letter to the House Ways and Means Committee's Subcommittee on Health urging support for HR 1185 in response to the subcommittee's May 17, 2016 hearing on modernizing the tax code to improve health care.
  5. Advocated for this issue as an AAOMS priority at the 2015 and 2016 Days on the Hill.
  6. AAOMS maintains an active grassroots congressional letter-writing campaign on the issue.
ANTITRUST REFORM

The “Competitive Health Insurance Reform Act” (HR 494) 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 bill sponsor and dentist Rep. Paul Gosar (R-AZ) expressing support for HR 494.
  2. Signed onto an ODC comment letter to Rep. Gosar that expressed support for HR 494.
  3. Advocated in support of antitrust reform as a secondary priority at the 2015 and 2016 Days on the Hill.
NON-COVERED SERVICES/ERISA REFORM

AAOMS supports legislation enacted in more than 37 states to prevent insurers from capping provider fees on dental services in which they do not cover. The DOC Access Act (HR 3323) would extend this prohibition to federally-regulated plans such as ERISA plans.

AAOMS ACTION:

  1. Signed onto an ODC Letter to sponsor Rep. Buddy Carter (R-GA) expressing support for HR 3323.
  2. Advocated in support of HR 3323 as a priority issue at the 2016 Day on the Hill.

The “Dental Insurance Fairness Act” (HR 1677) would improve value and transparency in health coverage by applying coordination and assignment of benefits requirements to self-insured group health plans (ERISA) that provide dental benefits.

AAOMS ACTION:

  1. Sent a letter to bill sponsor and dentist Rep. Paul Gosar (R-AZ) expressing support for HR 1677.
  2. Joined an ODC comment letter that expressed support for HR 1677.
STUDENT LOAN REPAYMENT REFORM

Student loan debt is a significant national problem, particularly for new graduates, and can play an influential role in career decisions, including with OMS residents.

AAOMS ACTION:

  1. Joined an ODC comment letter that expressed support for the Student Loan Interest Deduction Act (HR 509), which would increase the allowable student loan interest deduction from $2,500/year to $5,000/year and also eliminate the legal limit on how much income an individual can earn to claim the deduction.
  2. Signed onto ODC comment letters in 2015 and 2016 that expressed support for the Indian Health Service Health Professions Tax Fairness Act (S 536), which would amend the tax code to provide health care professionals who receive student loan repayments from the Indian Health Service (IHS) the same tax free status enjoyed by those who receive National Health Service Corps (NHSC) loan repayments.
  3. Advocated for student loan repayment reform as an AAOMS priority at the 2015 and 2016 Days on the Hill.
  4. AAOMS maintains an active grassroots congressional letter-writing campaign on the student debt reform issue.
ACCESS TO CARE

AAOMS encourages members of Congress to ensure oral health care services are given the utmost consideration in legislative proposals and actions when addressing access to care issues.

AAOMS ACTION:

  1. Signed onto an ODC comment letter that expressed support for the Action for Dental Health Act (HR 539), which would allow organizations to qualify for Centers for Disease Control and Prevention (CDC) oral health grants to support activities that improve oral health education and dental disease prevention.
PRESCRIPTION DRUG ABUSE

The nationwide prescription drug abuse epidemic has caught the attention of Congress and federal health officials through the introduction of legislative and regulatory initiatives impacting the way OMSs provide pain relief to their patients.

AAOMS ACTION:

  1. Discussed AAOMS's efforts to combat prescription drug abuse with members of Congress during the 2016 AAOMS Day on the Hill
  2. Sent letters in support of legislation (HR 4599/S 2578) to allow for partial filling of Schedule II drugs.
  3. Partnered with the Substance Abuse and Mental Health Administration and the National Institute for Drug Abuse to develop CE programs for AAOMS members.
  4. Sent a letter in May 2016 to Sen. Durbin (R-IL) outlining AAOMS's efforts to educate our members on opioid abuse.