Rep. Ike Skelton (D-Mo.) last week included language in the Defense Authorization Act of 2010, which was initiated by Rep. Joe Sestak (D-Pa.), that would raise to two-star status the chief dental officer in the Navy. The ADA has had a long-standing policy to pursue comparable ranks for the top dentists in all the services.

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The ADA and other concerned groups succeeded in getting the House Appropriations Financial Services Subcommittee to attach language to its appropriations bill that reflects our concerns over the way the FTC is interpreting the Red Flags Rule. Report language does not have the force of law, but it does help inform federal agencies of Congress’s intent in passing a law. A portion of the language appears below.

“While the Committee appreciates that the FTC has taken some steps to address the concerns of small businesses, the Committee believes more needs to be done.  The Committee requests the FTC further extend the stay of enforcement so the Commission can properly examine the impact of the Red Flags Rule on small businesses pursuant to the Regulatory Flexibility Act.”

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ADA staff worked last week with Mary Otto, a special correspondent for the Washington Post, for a health care reform article that appeared in the June 23 edition. Ms. Otto quoted Dr. Kathy O’Loughlin, the new ADA Executive Director. The article, entitled “Putting Teeth in Health-Care Reform,” is available online at www.washingtonpost.com/wp-dyn/content/article/2009/06/22/AR2009062201658.html.

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Health care reform is moving along in Congress, although at different paces, depending on the committee. The Senate Health, Education, Labor and Pensions (HELP) Committee has put together a draft document, for consideration.  HELP Committee members are gearing up for hearings later this month, with a markup of the legislation likely soon thereafter.

Meanwhile, both the Senate Finance Committee and the House Energy and Commerce Committee will in all likelihood have concrete legislative language to look at in the last week of this month, with markups likely around that time or sometime in the first part of July.

The Finance Committee is already getting flak over one floated option for financing reform through taxation of employer-provided insurance. The ADA has drafting a Dental-Only Coalition letter for the committee and is presently seeking cosigners, expressing opposition to any plan that would tax these benefits to pay for health care reform.

It is important to note that the most radical proposals for health care reform, including single-payer and Medicare-for-all are not under serious consideration by any of the committees.

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The Illinois State Dental Society (ISDS), working with the ADA Public Affairs program, is seeing a good deal of success with its "Bridge to Health Smiles" campaign and legislative agenda. The campaign was designed to create favorable public and legislative exposure for the ISDS, which in turn contributed to the Society's ability to get the following bills passed during a year of declining state revenues and budget deficits.

The first bill will allow dentists to invest Medicaid and SCHIP reimbursement payments directly into a state public employee retirement plan.  

The second bill amends the Loan Repayment Assistance for Dentists Act by making dental hygienists eligible for loan repayment assistance. The bill provides that an initial loan repayment assistance grant shall be for two years and that dentists may be awarded up to two subsequent one-year grants. Dentists and hygienists who receive these grants from the state must practice full time in designated shortage areas for the length of their grants awarded.

The third bill requires the Illinois Department of Healthcare and Family Services to administer a grant program to improve the public dental health infrastructure by developing comprehensive dental facilities at local health departments, federally qualified health clinics and rural health clinics. To receive these funds, a dental clinic must accept qualified out-of-area patients who need dental services, including emergency services for adults and services for referred Medicaid children. Medically Underserved Areas (MUAs) and Health Professional Shortage Areas (HPSAs) shall receive special priority for grants under this program.

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The Federal Trade Commission last week finally responded to concerns expressed by Rep. Nydia Velasquez, chairwoman of the House Small Business Committee, over the effect the agency's enforcement of the "red flags rule" might have on small businesses, particularly health care providers. Enforcement of the rule, which is designed to protect customers' financial information, has been pushed back to August. The ADA and others argue that Congress never intended the rule to burden small businesses.

In its letter, the FTC sought to assuage Chairwoman Velasquez's concerns, reiterating its earlier position that the burden on small businesses of its planned enforcement of the rule would be "minimal." The FTC letter in essence clears up nothing and the ADA will continue to lobby for passage of H.R. 2345, a bill that would exempt small businesses from the rule.

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A bill in the Ohio legislature would create a "public health oral supervision program," which would allow dentists to provide off-site supervision of hygienists in defined settings. Both parties would require a permit from the state dental board. In order to qualify, hygienists would have to complete two years of and acquire 3,000 hours of experience, have fulfilled all CE requirements, have completed a course pertaining to the practice of dental hygiene under public oral health supervision in a CODA-accredited program, and have completed a course in identifying and preventing medical emergencies.

The Ohio Dental Association developed the legislation and is supporting its passage.

The bill would require the supervising dentist to evaluate the hygienist's skills and authorize (in writing) the off-site work. The bill would also require the dentist to review the patients' most recent medical and dental history. The patient would have to be informed that no dentist would be present. Dental hygienists would be prohibited from diagnosing a patient's oral health care status.

After the completion of dental hygiene service, the hygienist would be required to refer the patient to the authorizing dentist for a clinical evaluation and schedule an appointment for the patient to see the dentist, and may not provide further care until the dentist evaluates the patient. The Dental Board is required to report annually to the governor and legislature tracking results of the new level of supervision.

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