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WASHINGTON REPORT
98-369, imposed a 15-month freeze on physician fees and offered incentives to physicians to accept assignment for all their Medicare patients. For a more exten sive report on this important legislation, see the August “Washington Report.” For the second consecutive year, Con gress approved an appropriation for the Department of Health and Human Ser vices (HHS), although its overall record on appropriations bills was unimpres sive. The bill the President signed in cluded line item amounts (in millions) as follows (the figures in parentheses are FY1984): National Institute of Dental Re search, $100.7 ($88 .2); National Health Wrap-up on 98th Congress’s Service Corps (operations), $75.0 ($91.0); National Health Service Corps (scholar health care legislation ships), $2.3 ($6.3); Disadvantaged Stu President Reagan and the 98th Congress dent Assistance, $24.0 ($18.2); General broke off their stormy relationship this Dentistry Training, $2.0 ($1.9); Preven fall less than gracefully. The President tive Health and Health Services Block inveighed against what he said was Con Grant (including fluoridation), $89.5 gress’s “wrong approach to health profes ($87.0); Com m unity Health Centers, sions training,” its “excessive” authori $360.0 ($336.6); Maternal and Child zations for some health programs, its con Health Block Grant, $478.0 ($398.4); and tinuation of others that he wanted to Centers for Disease Control (dental), $0.5 scrap, and its creation of new ones he ($0.5). The conference committee appointed d id n ’t want in the first place. House Speaker Thomas P. “T ip” O ’Neill, Jr., to resolve differences between the House (D-MA) said Congress had merely pro and Senate appropriation bills went be vided “a safety net against the excesses of yond the amounts alloted for NIDR by Ronald Reagan,” and the President took either chamber. The committee noted in some flak from Republican members of its report on the legislation that the ap Congress, too. Getting in the last word, he propriation for FY 1985 should include vetoed what he believed were the most $13.3 m illion to continue NIDR’s camobjectionable of the health bills sent to pus-based dental research institutes and him during Congress’ final days, which centers. The conferees also called for sev eral reports and studies from HHS, in seemed more like its final daze. But Ronald Reagan and the 98th Con cluding a plan for increasing the supply gress worked together often enough and of Hispanic health professionals and re well enough to bring about major changes search on “the preventive health value of in legislation affecting the health profes the independent practice of dental hysio ns, th e ir m u tu a l acrim on y n o t gienists, conducted in accordance with state law.” Funds were not provided for withstanding. Public Law 98-21, the Social Security either study. Amendments of 1983, dramatically al tered the way government does business with private sector providers of health care, creating a new reimbursement sys Separate authorizing legislation for some tem for Medicare based on diagnosis re HHS programs, including the National lated groups (DRGs). Hospitals formerly Health Service Corps and general den reimbursed on the basis of their costs for tistry training, was among the bills vetoed treating patients are now paid on the basis by President Reagan, but he said the ap of predetermined amounts. The law also propriations mechanism would provide directed the government to study the adequate authority for these programs feasibility of extending the DRG system to during FY 1985. The vetoed measure physicians, dentists,and other health care would have extended statutory authoriza professionals who provide care in hospi tion for dental general practice residen cies (GPRs) through FY 1987 and would tals to Medicare patients. have specified a percentage set aside under the family medicine and general dentistry authority for dental GPRs. Other legislation on which the 98th The Deficit Reduction Act of 1984, PL
General practice residencies
Congress and President Reagan reached agreement included the Defense Authori zation Act, PL 98-525, directing the ser vices to begin limited “space-available” dental care for military dependents next July 1; PL 98-527, requiring appropriate dental and medical services for severely disabled persons in institutions; PL 98305, making certain burglaries and rob beries of controlled substances— from p h a rm a c ie s , d e n tis ts , a n d other registrants— federal offenses; PL 98-417, providing longer patent protection for new brand-name drugs; PL 98-397, im proving pension benefits for women under private pensions plans; PL 98-474, strengthening cigarette warning labels; and PL 98-5 51, authorizing creation of 13 new centers for research on disease pre vention and health promotion by FY 1988. The President also signed two bills ex tending for 1 year the tax-free status of legal services and education benefits pro vided by employers as fringe benefits to their workers. But the Association played a strong role this year, in concert with the health insurance industry, labor, and other interests, in preventing action in the 98th Congress on the President’s proposal to put a ceiling on the amount of health insurance benefits workers could receive tax-free from their employers. That issue is certain to be considered by the 99th Congress, which convenes Jan 3, proba bly in the context of the tax status of all fringe benefits.
Continuation pay The Association also was successful last year in blocking legislation that would have eliminated continuation pay for m il itary dentists and this year played an ac tive role in securing an extension of bonus pays for dentists in the uniformed services. Other legislation mothballed in the 98th Congress, and subject to renewal in the next Congress, would have imposed limitations on Federal Trade Commission authority regarding state-regulated pro fessions, including dentistry; reestab lished categorical grant fu n d in g for fluoridation of community and schoolbased water systems (fluoridation grants were merged with other grants into the preventive health block grant); and eased the way for development of so-called “preferred provider organizations.”
Deficit Reduction Act
1010 ■ JADA, Vol. 109, December 1984
This column was prepared by Mr. Craig Palmer, public information counsel, ADA Washington Office.
WASHINGTON REPORT
98-369, imposed a 15-month freeze on physician fees and offered incentives to physicians to accept assignment for all their Medicare patients. For a more exten sive report on this important legislation, see the August “Washington Report.” For the second consecutive year, Con gress approved an appropriation for the Department of Health and Human Ser vices (HHS), although its overall record on appropriations bills was unimpres sive. The bill the President signed in cluded line item amounts (in millions) as follows (the figures in parentheses are FY1984): National Institute of Dental Re search, $100.7 ($88 .2); National Health Wrap-up on 98th Congress’s Service Corps (operations), $75.0 ($91.0); National Health Service Corps (scholar health care legislation ships), $2.3 ($6.3); Disadvantaged Stu President Reagan and the 98th Congress dent Assistance, $24.0 ($18.2); General broke off their stormy relationship this Dentistry Training, $2.0 ($1.9); Preven fall less than gracefully. The President tive Health and Health Services Block inveighed against what he said was Con Grant (including fluoridation), $89.5 gress’s “wrong approach to health profes ($87.0); Com m unity Health Centers, sions training,” its “excessive” authori $360.0 ($336.6); Maternal and Child zations for some health programs, its con Health Block Grant, $478.0 ($398.4); and tinuation of others that he wanted to Centers for Disease Control (dental), $0.5 scrap, and its creation of new ones he ($0.5). The conference committee appointed d id n ’t want in the first place. House Speaker Thomas P. “T ip” O ’Neill, Jr., to resolve differences between the House (D-MA) said Congress had merely pro and Senate appropriation bills went be vided “a safety net against the excesses of yond the amounts alloted for NIDR by Ronald Reagan,” and the President took either chamber. The committee noted in some flak from Republican members of its report on the legislation that the ap Congress, too. Getting in the last word, he propriation for FY 1985 should include vetoed what he believed were the most $13.3 m illion to continue NIDR’s camobjectionable of the health bills sent to pus-based dental research institutes and him during Congress’ final days, which centers. The conferees also called for sev eral reports and studies from HHS, in seemed more like its final daze. But Ronald Reagan and the 98th Con cluding a plan for increasing the supply gress worked together often enough and of Hispanic health professionals and re well enough to bring about major changes search on “the preventive health value of in legislation affecting the health profes the independent practice of dental hysio ns, th e ir m u tu a l acrim on y n o t gienists, conducted in accordance with state law.” Funds were not provided for withstanding. Public Law 98-21, the Social Security either study. Amendments of 1983, dramatically al tered the way government does business with private sector providers of health care, creating a new reimbursement sys Separate authorizing legislation for some tem for Medicare based on diagnosis re HHS programs, including the National lated groups (DRGs). Hospitals formerly Health Service Corps and general den reimbursed on the basis of their costs for tistry training, was among the bills vetoed treating patients are now paid on the basis by President Reagan, but he said the ap of predetermined amounts. The law also propriations mechanism would provide directed the government to study the adequate authority for these programs feasibility of extending the DRG system to during FY 1985. The vetoed measure physicians, dentists,and other health care would have extended statutory authoriza professionals who provide care in hospi tion for dental general practice residen cies (GPRs) through FY 1987 and would tals to Medicare patients. have specified a percentage set aside under the family medicine and general dentistry authority for dental GPRs. Other legislation on which the 98th The Deficit Reduction Act of 1984, PL
General practice residencies
Congress and President Reagan reached agreement included the Defense Authori zation Act, PL 98-525, directing the ser vices to begin limited “space-available” dental care for military dependents next July 1; PL 98-527, requiring appropriate dental and medical services for severely disabled persons in institutions; PL 98305, making certain burglaries and rob beries of controlled substances— from p h a rm a c ie s , d e n tis ts , a n d other registrants— federal offenses; PL 98-417, providing longer patent protection for new brand-name drugs; PL 98-397, im proving pension benefits for women under private pensions plans; PL 98-474, strengthening cigarette warning labels; and PL 98-5 51, authorizing creation of 13 new centers for research on disease pre vention and health promotion by FY 1988. The President also signed two bills ex tending for 1 year the tax-free status of legal services and education benefits pro vided by employers as fringe benefits to their workers. But the Association played a strong role this year, in concert with the health insurance industry, labor, and other interests, in preventing action in the 98th Congress on the President’s proposal to put a ceiling on the amount of health insurance benefits workers could receive tax-free from their employers. That issue is certain to be considered by the 99th Congress, which convenes Jan 3, proba bly in the context of the tax status of all fringe benefits.
Continuation pay The Association also was successful last year in blocking legislation that would have eliminated continuation pay for m il itary dentists and this year played an ac tive role in securing an extension of bonus pays for dentists in the uniformed services. Other legislation mothballed in the 98th Congress, and subject to renewal in the next Congress, would have imposed limitations on Federal Trade Commission authority regarding state-regulated pro fessions, including dentistry; reestab lished categorical grant fu n d in g for fluoridation of community and schoolbased water systems (fluoridation grants were merged with other grants into the preventive health block grant); and eased the way for development of so-called “preferred provider organizations.”
Deficit Reduction Act
1010 ■ JADA, Vol. 109, December 1984
This column was prepared by Mr. Craig Palmer, public information counsel, ADA Washington Office.