Big Advocacy Accomplishments for the Industry in 2016!
In politics, 2016 has been an unprecedented year dominated by a historical Presidential campaign, ending with the election of Donald Trump and a Republican-controlled Congress, who promise to undo much of the outgoing Administration’s accomplishments. While closely monitoring the political arena, NADP and the dental benefits industry continued our strong engagement in the work of state and federal legislatures and regulators as well as ongoing development of insurance Marketplaces.
Recognizing the importance of outreach to federal policymakers, the NADP Board of Directors in fall 2014 approved an industry-wide advocacy and legislative fly-in to Washington, D.C. A subgroup of the Government Relations Workgroup (GRW) provided critical guidance in planning for the first annual Advocacy in Action, which took place in May 2016.
Thirty dental benefits industry leaders traveled to the District of Columbia to participate in more than 40 meetings with congressional staff and policymakers. Advocates educated their representatives on the industry with statistics and information from their states and also discussed several key issues impacting the industry, including support for U.S. H.R. 3463 on Equitable Treatment, fixing the calculation of Advanced Premium Tax Credits (APTC), and expressing concern on H.R. 3233 which negatively impacts consumers’ access to discounts on noncovered services and unnecessarily complicates dental/vision provider contracts.
Advocacy in Action and the work of GR volunteers quickly saw dividends—within months of the fly-in, H.R. 3463 was included in a congressional hearing where legislators praised the bipartisan effort. Not long after, and another significant step forward, Senator Roberts (R-KS) and Senator Bennet (D-CO) introduced companion legislation in the Senate, S. 3244. The success we’ve seen on this front underscore the significant impact of consistent communication and engagement with policymakers.
On the regulatory side and after leading three years of diligent lobbying, we were thrilled to see the Administration finalize a new calculation of premium tax credits to include the value of pediatric dental benefits. NADP led the charge with industry stakeholders, including the American Dental Association, Children’s Dental Health Project, Delta Dental Plans Association and many other oral health leaders. While there is no certainty the change will be put into effect during the transition in the Affordable Care Act anticipated under the Trump Administration, having dental included in the corrected formula can be helpful in discussion of future iterations on tax credits or tax deductibility of benefits.
Numerous other regulations commanded our attention this year. The Centers for Medicare and Medicaid Services (CMS) finalized the first major regulatory revision to Medicaid managed care since 2002 with several provisions impacting dental benefits including dental loss ratios, quality measures, rate-setting and network adequacy. The Medicaid Managed Care regulation—often referred to as the ‘Mega Reg’ for its length and breadth—inspired NADP members to establish a Member Interest Group (MIG) focused on Government Funded Programs. The new MIG helped direct a joint project between NADP and the Delta Dental Plans Association to summarize the rule by Michael Adelberg (formerly of Center for Consumer Information and Insurance Oversight (CCIIO)) and his team at FaegreBD Consulting.
The Department of Labor (DOL) proposed equally complex provisions and changes to the Form 5500, which employers are required to fill out annually related to employee benefits. The proposed rule would greatly increase in size and therefore cost and time for employers as well as dental carriers who would be required to forward new information on items such as claims utilization. The Commission on Advocacy Policy (CAP) established a subgroup who, over several months, analyzed the new reporting forms for impacts to dental benefits and employer offerings to develop comments from the industry.
As public health and insurance topics continue to command public attention and discussion, GR volunteers see several policy trends and areas of focus on the horizon. State legislative activity to implement the National Association of Insurance Commissioners” (NAIC) updated Network Adequacy Model Act will continue to grow across the country. A subgroup of the GRW is dedicated to monitoring these developments, responding to policy proposals and developing advocacy resources for member plans in their states. GR volunteers also see the potential and growing push for legislative discussion about dental loss ratios (DLR) and a subgroup of the Commission on Advocacy Policy (CAP) is meeting bimonthly to consider these proposals in-depth and plan a strategic approach to multi-state activity. Other issues we anticipate will continue to garner attention on the state level include mid-level providers, provider contracts, dental service organizations, external appeals, taxes, electronic data, coordination of benefits and more.
NADP tracks and responds to a full range of topics outlined above. There is a wealth of information on these and other topics that is available for members, easily accessible online:
In the coming year, these policy areas and new ones will continue to challenge us; however, we must pause and recognize our great achievements and the industry’s bright opportunities. With strong leadership and GR volunteer engagement, the dental benefits industry is well poised to develop and achieve our goals during this time of transition and well beyond 2017.
If you would like to learn more about GR volunteer group initiatives and NADP’s GR Department, please feel free to reach out to NADP staff: