AAOMS Advocacy E-news
June 20, 2017

For further information, contact:
Adam Walaszek
Governmental Affairs Department


Federal Affairs

Vote on medical malpractice legislation postponed

Due to the June 14 tragic shooting near our nation's capital, previously planned congressional activity for the rest of the week was upended. As a result, the planned House floor vote on medical malpractice reform legislation (HR 1215) – scheduled for June 15 – was postponed.

As we wait for the vote to be rescheduled, please take this time to use our grassroots advocacy campaign to urge your U.S. Representative to vote “yes” on medical malpractice reform. More than 200 of your colleagues have already sent messages to their constituent House members on this important issue. Please add your voice if you have not already done so.

Republican healthcare reform moves to the Senate

GOP House leadership sent its Obamacare replacement bill, the American Health Care Act (AHCA), to the Senate for review on June 6 after the Senate Parliamentarian ruled that the bill met the requirements for passing via reconciliation.

Senate GOP leaders previously indicated they would draft their own health reform bill after the Congressional Budget Office’s score for the bill predicted a loss of insurance for 23 million Americans. The loss would be due in part to a rollback of ACA’s Medicaid expansion, capped Medicaid payments to states and the ability of states to free restrictions on insurers covering those with pre-existing conditions and waive essential health benefit requirements.

Senate Majority Leader Mitch McConnell stated his goal is to get the Senate GOP’s health reform bill to the Senate floor for a vote before the July recess, which takes place during the first week of July; however, others have stated that deadline is overly ambitious. McConnell and his health reform working group of 13 senators have yet to set an official date when their replacement bill will be released.

A contentious issue among GOP senators remains how to move forward with payments to states that expanded their Medicaid programs under Obamacare. McConnell has suggested phasing out payments made under the ACA Medicaid expansion in three years, but other senators are pushing for more time with a seven-year plan. Many other details of the anticipated legislation remain unknown.

AAOMS signed on to a letter on June 9 with other members of the Organized Dentistry Coalition to the Senate Committee on Finance to reinforce the importance of oral health as the Senate evaluates potential changes to Medicaid and the definition of essential benefit packages during ACA repeal/replace efforts.

Congress begins planning for FY 2018 appropriations

Members of the House are moving quickly to make plans for how they want to address the approaching FY 2018 budget deadline. The budget planning process is significantly behind the traditional schedule, so House appropriators have indicated they may seek to pass a single 12-bill appropriations package before the August recess given their time constraints. The Trump Administration released its full budget plan for FY 2018, but it is unclear how much of the plan legislators will use when crafting the anticipated 12-bill appropriations package.

The Trump Administration’s FY 2018 budget proposal, released May 22, includes approximately $627 billion in cuts to Medicaid over the next 10 years, changing it from an open-ended federal commitment to a system of capped contributions to states. The proposal would also factor in the $7.6 billion accounting expense of terminating the Medicare Independent Payment Advisory Board (IPAB). Additionally, the National Institutes of Health (NIH) would take a $5.6 billion cut and the Children’s Health Improvement Program would take a $5.8 billion cut over 10 years.

NIH director to remain in position

President Donald Trump on June 6 confirmed that NIH Director Dr. Francis Collins will remain in his position. Dr. Collins was appointed by the Obama Administration and has been NIH Director since 2009. He was previously a physician-geneticist who worked as Director of the National Human Genome Research Institute at NIH from 1993 until his 2009 appointment. Additionally, Director Collins was awarded the Presidential Medal of Freedom in 2007 and received the National Medal of Science in 2009.

Facebook launches engagement tool

Facebook recently launched a new tool that may be useful to OMSs interested in engaging with their constituent lawmakers. Facebook users can pin the “constituent badge” to their profile, letting friends – and members of Congress – know which district they live in.

There are several advocacy benefits that may arise from this new tool. For example, when a constituent follows a member of Congress and comments on a lawmaker’s post, the lawmaker knows it is coming from a constituent, and as a result, may be more mindful of the comment than if it came from a non-constituent.

The constituent badge also allows lawmakers to make their posts available exclusively to voters in their district. Some members of Congress are using the constituent badge to organize virtual town hall meetings with an exclusive audience of their own constituents via the Facebook Live streaming medium. More specific information can be found at www.facebook.com/help/157047021494292.

State Affairs

Arizona restores emergency dental benefits

After seven years of lobbying by the Arizona Dental Association (AzDA), the state’s legislature passed a budget bill (SB 1527) that included a provision restoring emergency dental benefits to adults in the state’s Medicaid program. The bill sets a $1,000 cap for emergency dental care and extractions.

During the Great Recession, the state eliminated adult dental benefits from the Arizona Health Care Cost Containment System (AHCCCS), the state’s Medicaid program, resulting in a higher number of patients seeking emergency dental care from the state’s emergency rooms. While AzDA would like to see more comprehensive benefits added for adult AHCCCS patients, this is a first step toward that goal. For more information, contact AzDA.

Missouri session ends without PDMP approval

Legislation (HB 90) died in Missouri that would have established a state prescription drug monitoring program (PDMP). The bill died after the sponsor, Rep. Holly Rehder (R), refused to accept amendments proposed by Sen. Rob Schaaf (R), a physician who has annually opposed (and in many cases filibustered) the creation of a PDMP on privacy grounds. Sen. Schaaf’s amendments would have threatened existing systems in the state’s counties and required a purge of all data within the system every 180 days. Missouri remains the only state in the country without a PDMP.

Texas Dental Board Sunset Bill enacted

Texas Gov. Greg Abbott (R) signed SB 313 on May 29, continuing the Texas State Board of Dental Examiners (TSBDE) and revising the state’s dental practice act. The Texas Society of OMS (TSOMS) has been involved throughout the sunset review process, testifying at every hearing and contributing to the discussion as the process moved forward.

Among many provisions, the final bill requires dentists to check the state’s PDMP prior to issuing a prescription for an opioid, establishes an anesthesia advisory board, revises sedation permit structures and authorizes the Board to 1) require notification by dentists who will be performing anesthesia services in more than one location and 2) establish additional requirements for dentists performing procedures on high-risk patients. It also requires PALS certification to treat pediatric patients, establishes minimum emergency procedure standards and requires capnography to be used for deep sedation or general anesthesia. TSBDE must still develop regulations to implement many of these provisions. Questions? Contact TSOMS.

Health Information Technology

HHS reminds providers of ransomware guidance

In light of the recent WannaCry ransomware attack, HHS is reminding those in healthcare to adhere to the ransomware guidance of the HHS Office for Civil Rights’ (OCR) and implement necessary data security measures. If a provider is hit with a ransomware attack, HHS considers this a HIPAA-related breach, which must be reported to OCR no later than 60 days after the entity knew or should have known of the breach. In addition, if a ransomware attack has occurred, providers should activate their incident response plan and contact their local FBI or U.S. Secret Service field office.

Practice Management

Meaningful use hardship deadline is July 1

Medicare providers who did not meet the requirements of the Meaningful Use program in 2016 must submit a hardship application by July 1 to avoid a 3 percent payment adjustment on their 2018 professional fees. Providers are eligible for a hardship exception due to reasons specified in the application. Only one application needs to be submitted per practice. For more information, visit the CMS website or contact CMS at 888-734-6433, option 1.

CMS updates Advanced Beneficiary Notice of Non-coverage

CMS has added new language to the ABN, informing beneficiaries of their rights to CMS nondiscrimination practices and how to request an ABN in an alternative format if needed.

All Medicare providers must use the new form by June 21. To verify you are using the correct ABN, the expiration date in the lower left corner should be 03/2020.

For more information on the new ABN form, visit the CMS website at www.cms.gov/Medicare/Medicare-General-Information/BNI/Downloads/ABN-Form-Instructions.pdf.

Reporting program applies to certain practices

Beginning July 1, any Medicare-enrolled OMS meeting the following criteria who renders a procedure on CMS’s list will be required to report CPT code 99024- “postoperative follow-up visit normally included in the surgical package” for each postoperative visit rendered associated with that procedure. OMSs required to report include those who:
  • Practice in larger practices (10 or more practitioners).
  • Practice in the states of Florida, Kentucky, Louisiana, Nevada, New Jersey, North Dakota, Ohio, Oregon and Rhode Island.
  • Render a procedure(s) included on CMS’s list. Commonly performed OMS procedures such as implant removal, biopsy of the mouth and destruction of lesions are included on this list.
OMSs in practices with fewer than 10 practitioners or those practicing in other states are exempted from this mandatory reporting requirement but are encouraged by CMS to report if feasible.

For more detailed information on the reporting of 99024, visit the CMS website at www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/global-surgery-data-collection-.html.

Medicare beneficiary identifiers to increase protection

Beginning in 2018, CMS requires Medicare beneficiaries’ social security numbers (SSN) to be removed from all Medicare beneficiary ID cards in order to increase protection against fraud and identity theft. The SSN will be replaced with a Medicare Beneficiary Identifier (MBI). CMS will be sending Medicare beneficiaries new Medicare cards.

While providers will have a 21-month transition period to use the patient’s SSN or the newly assigned MBI, OMSs are encouraged to begin using their Medicare patients’ new Medicare card and number as soon as presented. For more information, visit the CMS website at www.cms.gov/medicare/ssnri/index.html.

MIPS participation status tool available

This year, OMSs may have received letters from their Medicare administrative contractors (MACs) that provided information about a practice’s 2017 participation status in the Merit-based Incentive Payment System (MIPS).

If you did not receive a participation status letter, CMS has created an online tool where providers can check if they are exempt from MIPS by entering their National Provider Identifier (NPI).

If exempt from MIPS during the first reporting period, the provider does not need to do anything further for the 2017 calendar year. If included in MIPS, the provider will be required to successfully report information from the four MIPS categories to avoid a penalty in 2019.

More information on the penalties can be found on the AAOMS website at www.aaoms.org/practice-resources/coding-reimbursements/information-material/medicare/macra-summary.

For more information on MIPS eligibility, visit the CMS website at qpp.cms.gov/learn/qpp.

Webinar to focus on HIPAA compliance, data protection

OMS practices in violation of HIPAA regulations can incur costly penalty fees. The importance of understanding the HIPAA Omnibus Rule and HIPAA compliancy requirements cannot be overstated.

On Sept. 12, AAOMS will host a 90-minute webinar, “HIPAA Compliance and Data Protection: How to Protect Your Practice and Your Reputation.” Topics covered will include HIPAA Omnibus Rule requirements, compliancy-related vulnerabilities related to practices and how to protect against ransomware attacks.

For more information or to register for this webinar, visit www.pathlms.com/aaoms/courses/4892.

CDC mobile app helps providers

In Dec. 2016, the CDC released an app to assist providers in following the CDC’s Guideline for Prescribing Opioids for Chronic Pain. Writing lower dose prescriptions and helping patients taper off of opioids can be met with resistance. The app is designed to help doctors through these difficult conversations with patients and provides tips on effective communication skills. Providers can also use the app to role play conversations with a virtual patient. To learn more, visit cdc.gov/drugoverdose/prescribing/app.html.
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