The former U.S. House speaker uses his latest column to highlight some of the 1,968 powers assigned in the 2010 federal health care reform legislation to the U.S. secretary of health and human services:

1. The Secretary determines ?clinical concern?of drugs — Section 3307 — (ii) IDENTIFICATION OF DRUGS IN CERTAIN CATEGORIES AND CLASSES. (I) ? the Secretary shall identify, as appropriate, categories and classes of drugs for which the Secretary determines are of clinical concern. (II) CRITERIA. The Secretary shall use criteria established by the Secretary in making any determination under subclause (I). (iii) IMPLEMENTATION. The Secretary shall establish the criteria ? and any exceptions ? through the promulgation of a regulation which includes a public notice and comment period.

Meaning: The Secretary will decide what clinical drugs seniors can access.

2. Secretary decides how drugs are dispensed in long-term care facilities — Section 3310 — (3) REDUCING WASTEFUL DISPENSING OF OUTPATIENT PRESCRIPTION DRUGS IN LONG-TERM CARE FACILITIES. The Secretary shall require PDP sponsors of prescription drug plans to utilize specific, uniform dispensing techniques, as determined by the Secretary, in consultation with ? any other stakeholders the Secretary determines appropriate … when dispensing covered part D drugs to enrollees who reside in a long-term care facility in order to reduce waste associated with 30-day fills.

Meaning: The Secretary will instruct physicians and nurses exactly how to give a drug to their patients in long-term care facilities.

3. ?Tooth-level surveillance? — Section 4102– (2) NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY. The Secretary shall develop oral healthcare components that shall include tooth-level surveillance for inclusion in the National Health and Nutrition Examination Survey ? the term ?tooth-level surveillance? means a clinical examination where an examiner looks at each dental surface, on each tooth in the mouth and as defined by the Division of Oral Health of the Centers for Disease Control and Prevention.

Meaning: The Secretary will determine how dentists and dental hygienists should examine your teeth.