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A G reat D entist Goes to Washington

A G reat D entist Goes to Washington. Capitol Hill Meeting Logistics & Overview of Issues. Why Does Advocacy Matter?. U.S. Government must address the needs of: Millions of Americans Infinite number of issues Thousands of advocacy groups Limitations: Time Money Manpower

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A G reat D entist Goes to Washington

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  1. A Great Dentist Goes to Washington Capitol Hill Meeting Logistics & Overview of Issues

  2. Why Does Advocacy Matter? • U.S. Government must address the needs of: • Millions of Americans • Infinite number of issues • Thousands of advocacy groups • Limitations: • Time • Money • Manpower • If you want your piece of the pie, you have to educate and advocate!

  3. How Do Members of Congress Decide Which Issues to Support? • Serves a compelling national interest • Strong local support from constituents • Factually-based • Anecdotal evidence

  4. How Do Members of Congress Decide Which Issues to Support? • Constituent communications do make a difference • Just 5 – 10 communications can put an issue on a Member’s radar screen • 20 – 100 communications is nearly always enough to sway a Member

  5. Background on Congress What You Need to Know

  6. The Basics House of Representatives • 435 seats – elected by district • Each district contains approximately 650,000 people • More populous states have larger delegations • Reapportioned every 10 years by state • 2-year term Senate • 100 seats – elected by state • 2 Senators per state • 6-year term - staggered

  7. Division of Power House of Representatives • 254 Democrats • 177 Republicans • 4 Vacancies • Majority Rules Senate • 57 Democrats • 41 Republicans • 2 Independents (Caucus w/ Democrats) • 60 votes to be “filibuster-proof”

  8. Committee Structure House of Representatives • Appropriations • Labor, Health & Human Services, and Education • Energy & Commerce • Health Subcommittee • Ways & Means • Health Subcommittee • Education & Labor Senate • Appropriations • Labor, Health & Human Services, and Education • Health, Education, Labor, and Pensions (HELP) • Finance

  9. Congressional Office / Staff Organization • Washington, D.C. Office • Policy • State / District Offices • Casework

  10. Chief of Staff or Administrative Assistant Legislative Director Legislative Assistant Legislative Assistant Legislative Assistant Legislative Assistant Legislative Correspondent Legislative Correspondent Washington Office Organization:Legislative Staff

  11. Chief of Staff or Administrative Assistant Appointment Secretary or Scheduler Office Manager Communications Director or Press Secretary Receptionist or Staff Assistant Interns Washington Office Staff:Non-Legislative Staff

  12. District Director Scheduler Caseworker Caseworker Caseworker State / District Office Staff

  13. Tips for In-Person Meetings • Be Prompt, Patient, and Polite • You have to be on time for the meeting; they do not. • Anger is not an effective advocacy tool, so focus on the positive. • Be Prepared and Concise • You probably have no more than 15 minutes. • Make sure to have your facts straight - prepare or use "talking points". • Be Responsive • Answer any questions to the best of your abilities. • If you do not know the answer to something, say so and offer to get back to them. • Provide “Leave-Behind” materials. • Offer yourself as a resource to the Member and his/her staff.

  14. Tips for In-Person Meetings • Follow Up! • Collect business cards from everyone in the meeting. • Write detailed thank you letters. • Hold the Member and his/her staff accountable. • Let AGD know about your meeting by filling out and mailing in your “scorecards”.

  15. The Issues • ERISA Reform • Red Flags • McCarran - Ferguson

  16. ERISA Reform • Employee Retirement Income Security Act of 1974 • Every Ridiculous Idea Since Adam • Governs self-insured employee benefit plans • Most large employers • Health benefits

  17. ERISA Reform • Rep. Rob Andrews (D-NJ) • Chair of House Education & Labor Subcommittee on Health, Employment, Labor, and Pensions • H.R. 5000 – The Dental Coverage Value and Transparency Act of 2010

  18. ERISA Reform – H.R. 5000 • Prohibits dental benefits carriers governed by ERISA from capping fees for non-covered services • Other Items • Coordination of benefits • Designation of payment to non-participating dentist • Equal reimbursement for in-network and out-of-network dentists • Prohibits bundling of payments • Prohibits changing benefit code

  19. ERISA Reform – H.R. 5000: The Ask • House: Please cosponsor H.R. 5000 • Senate: Please support H.R. 5000 if it comes before the Senate and/or support companion legislation when/if it is introduced

  20. Red Flags • Fair and Accurate Credit Transactions (FACT) Act of 2003: Prevent Identify Theft • Federal Trade Commission (FTC) “Red Flags” Regulation (November 2007): • Requires financial institutions and “creditors” to implement written policies to address “red flags”

  21. Red Flags • No mention of health care providers in FACT Act or Red Flags regulation • FTC ruled that health care providers are “creditors” • Federal statute: Any person who regularly extends, renews, or continues credit

  22. Red Flags • NOT the intent of Congress to include health care providers (especially small businesses) as creditors • Red Flags implementation/enforcement delayed several times • Currently, enforcement begins June 1, 2010

  23. Red Flags – H.R. 3763 • Rep. John Adler (D-NJ) • Excludes health care, accounting, and legal practices with fewer than 20 employees • Passed the House in October 2009 by a vote of 400 – 0 • FTC supports passage

  24. Red Flags: The Ask • House: Thank you for supporting the Adler bill • Senate: Please urge Senate Majority Leader Harry Reid to bring H.R. 3763 to the floor and pass it prior to June 1st

  25. Overturn McCarran - Ferguson • McCarran – Ferguson Act: • Passed in 1945 • Reserves as the domain of the States the “business of insurance” • Exempts insurers from federal antitrust laws and regulations

  26. Overturn McCarran – Ferguson • States have proven unwilling or unable to regulate health insurers effectively • Consolidation, monopolies / oligopolies • Anti-competitive practices: • Price fixing • Bid rigging • Market allocation • Providers and patients disadvantaged

  27. Overturn McCarran – Ferguson • Health care reform: • House included partial repeal of McCarran – Ferguson • Senate did not include repeal • Final version: no repeal

  28. Overturn McCarran – Ferguson: H.R. 4626 • The Health Insurance Industry Fair Competition Act • Rep. Tom Perriello (D-VA) • Overturns the McCarran – Ferguson federal antitrust exemption for health insurers • Permits antitrust oversight by the Department of Justice and the Federal Trade Commission • Passed the House in February 2010 by a vote of 406 - 19

  29. Overturn McCarran – Ferguson: The Ask • House: Thank you for supporting H.R. 4626 • Senate: Please urge Senate Majority Leader Harry Reid to bring H.R. 4626 to the floor of the Senate and pass the legislation • NOTE: In February, 18 Senators joined Senate Judiciary Chairman Senator Patrick Leahy (D-VT) in urging Sen. Reid to bring to the floor legislation overturning McCarran – Ferguson’s antitrust exemption for health insurers

  30. Other Issues: Health Care Reform Several outstanding issues in implementation for organized dentistry: Insurance Reforms and New State Exchanges • Implementation and definition of the new pediatric dental benefit • Treatment of standalone dental benefit plans within the new state-run health insurance exchanges

  31. Health Care Reform New Public Oral Health Programs • Implementation of the new Public Oral Health Programs: • Oral health care prevention education campaign • Grants to support research-based dental carries disease management • Implementation of school-based dental sealant programs • Implementation of new funding for oral health infrastructure • Implementation of new authorities relative to oral health surveillance programs • Implementation of grant programs for school-based health centers

  32. Health Care Reform Dental Workforce Issues • Changes to the Title VII dental workforce programs • Implementation of and appropriations for the alternative dental health care providers demonstration • Creation of the new National Health Care Workforce Commission • Efforts to expand the dental health aide therapist (DHAT) program beyond Alaska

  33. Health Care Reform Employer Responsibilities and Small Business Programs • Implementation of employer responsibilities • Implementation of new small business tax credit programs and other assistance programs • Implementation of the Small Business Health Options Program (SHOP)

  34. Health Care Reform Other Miscellaneous Matters • Efforts to address Medicaid reimbursement levels • Regulatory efforts regarding changes to medical equipment to increase accessibility for the disabled • Expansion of Community Health Centers program

  35. Final Note • Please fill out and send back your “scorecards” • Good Luck!

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