Welcome to the AAOMS Advocacy Insider, the exclusive publication for members of AAOMS’s grassroots program, the OMS Action Network. Visit AAOMS.org/Action for more information on the OMS Action Network and past editions of the AAOMS Advocacy Insider.

Items of Note

Ensure all states have OMSs at Day on the Hill 

Be sure to register to attend the March 25-26 Day on the Hill. More than 90 oral and maxillofacial surgeons will be on the Hill advocating for the specialty, but many states still lack representation.

Participation by OMSs from the following states is still needed: Alaska, Arizona, Arkansas, Connecticut, Hawaii, Idaho, Indiana, Kentucky, Missouri, Nevada, New Mexico, North Dakota, South Dakota, Utah, Vermont, West Virginia and Wyoming. Remember, legislators are most receptive to the voices of their constituents. 

AAOMS has a limited number of funding spots still available to cover complimentary airfare and one night’s lodging. Please contact Paula Kantas at pkantas@aaoms.org to find out if you qualify.  

AAOMS welcomes first-time attendees and will ensure that all are effectively prepared for their congressional meetings. No prior experience is necessary. Watch what AAOMS Fellow Dr. Claudine Cafferata and ROAAOMS member Dr. Praveen Kumar R. Guntaka had to say following their experiences attending this annual advocacy event.

The housing block closes on March 3; register and make hotel reservations today. 

Elevate Your Advocacy: Join the AAOMS Advocates Circle

The AAOMS Advocates Circle is an elite group within the OMS Action Network, recognizing oral and maxillofacial surgeons who go above and beyond in advocacy. Members earn this distinction by completing key advocacy activities within a calendar year, strengthening the profession’s influence and shaping healthcare policy.

Take your advocacy to the next level and make a lasting impact. For questions about your status, contact the AAOMS Governmental Affairs Department.

State Updates

Ohio takes aim at specialty recognition

AAOMS signed onto a coalition letter opposing recent revisions proposed by the Ohio State Dental Board regarding specialty advertising regulations. The letter, supported by multiple national and state dental specialty organizations, urges the Board to revert to a 2018 proposal that upholds established specialty definitions defined by CODA-accredited residency, ensuring patient protection. However, if the Board moves forward with the current proposal, the coalition insists on specific revisions to address concerns. The letter follows a similar effort by the group in January to advocate for bona fide specialty recognition.

Nevada proposes dual-licensee remedies

At the request of the Nevada Society of Oral and Maxillofacial Surgeons, the legislature introduced AB 221. The bill would exempt dual-licensed oral and maxillofacial surgeons from anesthesia requirements imposed by the state medical board if they primarily practice under their dental license and already undergo inspections by the state dental board.

Currently, dual-licensed oral and maxillofacial surgeons in Nevada face an administrative burden due to conflicting or contradictory requirements from the two boards. AB 221 seeks to streamline regulations and reduce redundant oversight for these practitioners, ensuring they can focus on patient care without unnecessary regulatory hurdles.

New reimbursement cap proposed in states

Multiple bills have been proposed to cap both in-network and out-of-network fees at 200 percent of Medicare rates or 200 percent of Medicaid rates if not covered by Medicare. In practical terms, in-network rates tend to be below this threshold, whereas out-of-network rates are significantly higher.

AAOMS is currently tracking such proposals in Oklahoma (SB 787) and Massachusetts (SD 1569). Previously, these types of proposals were limited to hospital fees or surprise billing scenarios, but the scope now appears to be expanding.

CRNAs introduce proposals in several states

As anticipated, AAOMS is tracking 35 bills across multiple states aimed at expanding CRNA practice. These bills have been introduced in Georgia, Illinois, Indiana, Kansas, Mississippi, Missouri, Nebraska, New Jersey, New Mexico, New York, Ohio, Oklahoma, South Carolina, Texas, and Virginia.

Notably, several of these proposals would grant CRNAs independent practice in dental offices. In many cases, they would also exempt dental practitioners from securing an anesthesia permit, undergoing dental board office inspections, or complying with other dental board regulations.

States are encouraged to coordinate efforts on these bills with their state medical and anesthesiologist colleagues to ensure a unified response.

Dental therapy gaining traction

Recently, Florida, Illinois, Massachusetts, New Jersey and Oklahoma have introduced legislation that would allow dental therapists to practice. Currently, fourteen states allow for dental therapy in some capacity, whether it be statewide or restricted to underserved areas or tribal lands. 

Caution urged on bills with craniofacial implications

A growing trend in state legislatures is the introduction of bills addressing gender affirmation surgery and procedures. Many of these bills contain broad definitions of the procedures included within this category and may inadvertently include orthognathic and cleft procedures.

Based on its experience at the federal level with the Ensuring Lasting Smiles Act, AAOMS is actively working to educate state societies on these bills and their potential interpretations, which may impact craniofacial procedures performed by oral and maxillofacial surgeons.

Such legislation has already been introduced in Kentucky and Virginia, and AAOMS continues to monitor developments in other states.

Oregon removes stigmatizing language from applications

After extensive advocacy efforts, Oregon has removed stigmatizing mental health questions from its dental licensure applications. On Dec. 13, 2024, the Oregon Board of Dentistry voted to eliminate “have you ever” questions related to counseling, therapy, or treatment for mental health and substance use. The Oregon Dental Association led the effort alongside the Oregon Dental Hygienists’ Association and other stakeholders. The changes align with the Oregon Medical Board’s language and aim to reduce stigma, encouraging licensees to seek care without fear of repercussions. The updated application language is expected to take effect by February.

Dualling Dental Compact bills introduced in states

In 2024, the Dentist and Dental Hygienist Licensure Compact became operational, with 10 states enacting Compact legislation. Bills are currently under consideration in Arizona, Arkansas, Indiana, Maryland, Massachusetts, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, Oklahoma, Oregon, Pennsylvania, Texas and Vermont.

Meanwhile, the American Association of Dental Boards (AADB) proposed Dental and Dental Hygiene Licensure Compact is gaining traction. The AADB has launched a legislative tracking map and fact sheets, though no states have adopted the AADB legislation yet. Bills are pending in Maryland, Massachusetts, Mississippi, Missouri, Oklahoma and Texas.

Federal Updates

Congressional activity overview

Two notable issues dominating the focus of congressional leaders right now are passing legislation to finalize fiscal year (FY) 2025 appropriations and using the reconciliation process to advance President Trump’s top priorities: border protection, energy policy, military funding, an extension of the 2017 tax cuts, and new tax cuts. 

Last December, the 118th Congress extended FY 2025 funding through March 14 before adjourning. Unless Congress passes another extension or legislation to fund government agencies for the remainder of the fiscal year, the government faces a shutdown. Additionally, House Republicans will likely need Democratic support for either scenario, given their slim majority. Meanwhile, Republicans in both the House and Senate have struggled to unite around the contents and strategy of a reconciliation package. Reconciliation is a legislative process that allows a bill to pass with a simple majority in the Senate, thereby avoiding a filibuster. However, the effort has encountered several hurdles, including policy proposals that pit fiscal conservatives against moderates. 

Pressure is mounting on Republican congressional leaders to secure a legislative victory in the early months of President Trump’s term. Further disagreement remains over whether there will be one or two reconciliation packages. Three issues of importance to AAOMS that could emerge in a reconciliation package include small business tax refor

President Trump signs executive orders

President Trump issued several executive orders related to healthcare since taking office on Jan. 20. As previously reported, he issued directives to withdraw the U.S. from the World Health Organization and rescind executive orders issued in 2021 by former President Biden aimed at combating COVID-19 and protecting and strengthening Medicaid and the Affordable Care Act. Most recently, President Trump directed an end to federal support and research for gender affirming care for individuals under age 19 and called on DOJ to pursue litigation and legislation to oppose the practice. He also issued a temporary pause on federal loans and grants, causing confusion among healthcare non-profits and research institutions. Although this directive was quickly rescinded following legal challenges, uncertainty remains on whether the administration will continue to pursue similar efforts.

Take action to halt Medicare physician payment cuts

A bipartisan group of members of Congress, including several physicians, introduced the Medicare Patient Access and Practice Stabilization Act (HR 879) to address the 2.8 percent Medicare payment cuts that physicians, including OMSs, began incurring on Jan. 1. The legislation would provide a 6.62 percent payment update effective April 1 through the end of the year, which accounts for the lower first-quarter reimbursement, eliminates the existing reduction through the remainder of the year and addresses inflationary pressures. AAOMS has a grassroots campaign available urging Congress to pass this bill as soon as possible. Add your voice to our efforts!

House passes bill targeting fentanyl-related substances

The U.S. House passed Feb. 6 the HALT Fentanyl Act (HR 27), which aims to permanently classify fentanyl-related substances as Schedule I drugs, imposing stricter regulatory and enforcement measures. Notably, the bill does not affect medical-grade fentanyl, which will remain a Schedule II drug. This legislation is part of ongoing efforts to combat the rise in overdose deaths caused by illicit fentanyl. A temporary DEA order that classified these substances as Schedule I in 2018 is set to expire in March. The bill now moves to the U.S. Senate for consideration.

Provider wellness bill reintroduced

The “Dr. Lorna Breen Health Care Provider Protection Reauthorization Act” was introduced in the House and Senate as S 266/HR 929. The bill, previously endorsed by AAOMS, would reauthorize the Dr. Lorna Breen Health Care Provider Protection Act, which passed in 2022, and supports access to mental and behavioral health support and treatment for healthcare workers. The legislation was included – but ultimately dropped – from the slim year-end spending package that was enacted last December. 

Legislative Sessions

States currently in regular session

Alabama, Alaska, Arizona, Arkansas, California, Connecticut, Colorado, Delaware, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming