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Governmental Affairs Department
Congress resumes session for 2018
Both the Senate and House have returned to work, with much of the 2018 legislative agenda yet to be determined. Speaker Paul Ryan (R-Wis.) is indicating he would like to take up entitlement reform after his success with the recent passing of tax reform. Senate Majority Leader Mitch McConnell (R-Ky.) has said passing entitlement reform through the Senate would be unlikely due to the slim majority of 51-49 the GOP currently holds and the need for a 60-vote majority to pass legislation outside of budgetary reconciliation. Legislators will likely focus on finalizing FY 2018 appropriations before tackling other legislative agenda items for the new year.
Additionally, as part of a deal struck with Sen. Susan Collins (R-Maine) to ensure her support for the recently passed Republican tax reform legislation, it is expected both the House and Senate will consider her proposed legislation to stabilize the ACA markets and reinstate cost-sharing subsidies to insurers. A timeline for consideration of the proposed legislation has not been confirmed.
FY 2018 appropriations still not finalized
With the current Continuing Resolution (CR) extending government funding until Jan. 19, legislators must come to an agreement on adjustments to the current spending caps. A major element of the bipartisan debate remains whether to increase non-defense spending levels by an amount equal to defense increases. Other discussion topics include funding for the Children’s Health Insurance Program (CHIP), community health centers, disaster aid and immigration reform through the Dream Act of 2017. Once a spending cap agreement is reached, appropriators will be able to revise existing FY 2018 spending bills. It is likely another CR will be needed to ensure legislators have enough time to finalize FY 2018 appropriations.
Medical Device Tax moratorium expires
As of Jan. 1, the previous moratorium on the ACA’s Medical Device Tax expired. Legislators have indicated they may retroactively remove the tax as a part of the final FY 2018 appropriations package or separate legislation to extend the moratorium or repeal the tax altogether.
Urge Congress to repeal the Medical Device Tax ASAP. Please visit AAOMS’s grassroots website to view campaigns on other issues.
Day on the Hill registration now open!
Join your colleagues at the AAOMS Day on the Hill on April 17 and 18 in Washington, D.C., to advocate for issues important to the OMS specialty, your patients and your practice.
With so many healthcare changes taking place, don’t let important OMS issues go unheard.
No previous political or advocacy experience is necessary. AAOMS will provide you with essential information and handouts to make your legislative visits successful.
Complimentary round-trip coach airfare and one night of hotel accommodations are available for the first 30 registrants who have not attended Day on the Hill within the last five years. Act today as slots are filling up fast!
Visit AAOMS.org/DayontheHill for the complete schedule.
HHS Secretary nominee questioned at confirmation hearing
President Donald Trump’s nominee for HHS Secretary, Alex Azar, underwent a confirmation hearing before the Senate Committee on Finance on Jan. 9, largely focusing on Azar’s plans to counter drug price increases through the FDA and CMS. Additionally, a group of legislators from the House urged the Committee to inquire on Azar’s position on the suspension of cost-sharing subsidies to ACA insurers as well as the removal of the individual and employer mandates. Azar had a confirmation hearing before the Senate Committee on Health on Nov. 30 during which panel members were given the opportunity to question the nominee before a confirmation vote takes place. The Committee on Finance will determine whether to confirm Azar.
Michigan takes steps to address opioid abuse
States continue to take action to combat opioid abuse. In the final days of 2017, Michigan Gov. Rick Snyder (R) signed a series of bills on par with efforts in other states. HB 4408 requires prescribers to discuss the risks of addiction and controlled substances with guardians of minors prior to issuing their first prescription for an opioid. Minors whose treatment is associated with or incident to a surgery are exempt from this requirement. With the adoption of SB 166, all prescribers will be required to check the state’s Michigan Automated Prescription System (MAPS) prior to issuing a prescription for a controlled substance that is for more than a three-day supply. Also starting July 1, and due to the passage of SB 274, prescriptions for controlled substances for acute pain will be limited to a seven-day supply. Contact the Michigan Society of OMS with any questions.
Wisconsin places requirements on DSOs, patient records
Wisconsin law specifically allows non-dentists to own dental practices. In an effort to allow the state Dental Examining Board (DEB) some authority over these non-dental-owned practices, also known as dental service organizations (DSOs), the Wisconsin Dental Association, in collaboration with the Association of Dental Support Organizations, created language that provides protections for practitioners working in these groups.
SB 258, which was signed by Wisconsin Gov. Scott Walker (R), requires dental practices to preserve patient records for the amount of time determined by DEB rule. It also requires dental practices to transfer patient records if requested by a patient or person authorized by the patient. There have been reports of patients requesting their records from DSO practitioners, but because the practitioner in these arrangements does not actually control the records, they are not able to meet the statutory requirement of allowing patients access or forwarding the records to the DEB. This new bill would correct that scenario. The new bill also states a contract between a dentist and another party may not require the dentist to meet a minimum quota for the number of patients seen or procedures performed. Contact Wisconsin Dental Association with any questions.
New York Governor vetoes NCS bill
For many years, New York has had a provision in state statutes that was interpreted to prohibit insurers from capping fees for non-covered services (NCS). Because this provision was not explicit in preventing the practice, several insurers chose to ignore it and engage in NCS capping. In 2017, the New York State Dental Association introduced SB 6496, which would explicitly prohibit NCS capping. The bill was approved by the state legislature in the summer, but New York Gov. Andrew Cuomo (D) vetoed the bill on Dec. 18. In the governor’s veto message, he indicated the bill would limit cost-saving benefits to consumers and access to dental services. Thirty-nine states currently prohibit dental insurers from engaging in NCS capping. Contact the New York State Society of OMS with any questions.
Health Information Technology
OCR issues cybersecurity guidelines for traveling
In the HHS Office for Civil Rights (OCR) December newsletter, the agency provided several steps all providers and their staff should take while out of the office to protect their systems. Recommendations include bringing personal power adapters and cords, continuing to install security updates and patches, changing passwords, removing encrypted or sensitive information and avoiding public Wi-Fi. Providers also are reminded HIPAA rules and requirements apply even outside the office and on personal devices that may contain protected health information. The OCR website provides guidance on the HIPAA Security Rule and specific cybersecurity topics.
CMS clarifies position on texting
In a memo to state survey agencies, CMS indicates texting patient orders is prohibited regardless of the platform utilized. Providers are allowed, however, to message patient information through a secure platform that is encrypted and in compliance with HIPAA regulations. The memo notes computerized provider order entry (CPOE) is the preferred method of order entry by a provider.
CDC mobile app for infection prevention and control
The Centers for Disease Control and Prevention’s mobile app, DentalCheck, is designed to assist dental facilities in monitoring compliance with recommended infection prevention practices. This app is available on both Android and iOS devices and is based on the Infection Prevention Checklist for Dental Settings. Dental healthcare personnel can use this app to periodically assess infection prevention and control practices in their facility and ensure they are meeting the minimum expectations for safe care. Within the app, users can check “Yes/No” to acknowledge adherence to office policies, review basic infection prevention principles, link to full recommendations and source documents for dental healthcare settings as well as export or save notes for records management. For more information, visit the CDC’s website.
American Association of Oral and Maxillofacial Surgeons
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