ADVOCACY

District 4 Legislative Updates 2019

Written by Matilda Sullivan, VCU School of Dentistry Class of 2022, ASDA District 4 State Dental Association Chair

 

In 2019, we have seen remarkable changes in legislation through the collaboration of dental students representing District 4 and members of each state dental association. Hailing from Virginia, North Carolina, South Carolina, Tennessee and Georgia, our students have sought to represent the new voices in dentistry in each state represented by District 4. It’s important as dental students to be aware of ongoing changes in legislation that will impact our careers as we move into public or private practice upon the completion of our formal dental training. Below is an updated list on major legislative changes in the district.

 

 

Virginia
Silent PPO

During the 2019 session, the VDA’s primary task was to work on passage of the "Silent PPO" legislation, which requires insurance companies to notify participating dentists when they lease or sell their networks.  Delegate Lee Ware patroned the bill at the VDA’s request (HB1682).  This legislation passed both the House and Senate unanimously and was officially signed and approved by the Governor. It became effective on July 1, 2019.  Here is a link to more information on that legislation: https://www.vadental.org/advocacy/legislative-alerts/2019/07/11/vda-silent-ppo-legislation-enacted-on-july-1.

North Carolina

Dental Bill of Rights

North Carolina is now an even better place to practice dentistry thanks to the Dental Bill of Rights. The NC Dental Society helped successfully advocate on behalf of dentists for this common-sense legislation that will help mitigate overreach by dental insurance companies and allow dentists more control when participating in third-party payer networks. The legislation is one of the most comprehensive in the country and goes into effect January 1, 2020. The law accomplishes the following three goals:

Prohibits Mandatory Method of Payment by Virtual Credit Cards

  • The burden was previously placed on dentists to pay the credit card transaction fee. These fees can range from 2.5-5 percent of the charge, adding up to a significant annual expense for a dental practice.

  • Dental offices will no longer have to offset the transaction fees by passing the cost on to the patients.

Rental Insurance Network Transparency

  • Insurance carriers may rent their dental provider networks to other insurance carriers without the dentists’ knowledge or authorization. This results in dentists being forced to comply with the “in-network” provider terms even though they have not directly engaged with the other insurer.

  • This will reduce confusion for patients who are unaware of their out of pocket costs until after their claim is submitted and an EOB is received. When dental offices are unaware of their in-network status, this creates misunderstandings between the patient and dentists and can undermine the relationship.

Protects Prior Authorizations

  • This prohibits insurers from retracting prior authorizations for treatment.

  • Patients will be able to rely on the prior authorization to confirm which portions of and what level of treatment will be covered and what their out of pocket costs will be.

Dental Managed Care

North Carolina stopped the progress of bills introduced in the House and Senate that would include dentistry in the upcoming Medicaid transformation and bring dentistry into the commercial managed care model. Neither bill advanced.

Association Health Plans

The Small Business Healthcare Act became law without the Governor’s signature. The bill will allow businesses to join together to obtain individual health insurance through association health plans. It is estimated about 110,000 North Carolinians will benefit from signing up for an Association Health Plan. The NC Dental Society was successful in ensuring language was inserted to the bill that allows us to continue to serve our members through the NC Dental Society Healthcare Plan.

Dental Medicaid

North Carolina was able to maintain funding for Medicaid adult dental services, which is considered an “optional service” under Medicaid and is typically a topic for discussion during budget negotiations. 

 

South carolina

South Carolina’s legislature will meet late January 2020. The two items of focus right now are  (1) Amalgam Separators, which is a Federal law effective July 1, 2020, which the South Carolina State Dental Association is communicating with its members constantly, making them aware of this and (2) E-Prescribe, the legislation in SC does not take effect until January 1, 2021.  WalMart has made their announcement regarding e prescribe.

 

If you are a dental student in South Carolina, take the opportunity to contact your state legislators on these issues.

 

Tennessee

Revisions to the 2018 Opioid Legislation

Public Chapter 124 sponsored by Senator Shane Reeves R-Murfreesboro and Representative Cameron Sexton R-Crossville and backed by dentists, pharmacists and MDS revised a number of problematic provisions to the landmark opioid legislations enacted in 2018. Two of its provisions are significant to dentistry including a provision to clarify that a healthcare provider shall not be required to include and ICD-10 on any prescription for an opioid of a three-day supply and 180 morphine milligram equivalent.

In addition, the e-prescribing requirement for Schedule II, III, IV or V controlled substance was delayed for one year until January 1, 2021.

 

Georgia

Health Insurance Card Bill

Sponsored by Sen. Larry Walker, this bill requires that insurance companies state on patients’ health insurance cards that the insurance plan is “regulated by the GA Insurance Commissioner” if the plan is fully insured. This will help provider’s enforce GA’s prompt pay and assignment of benefits laws.

 

Medicaid Fee Increase

GDA’s Government Team secured a 3% dental Medicaid fee increase in the FY2020 budget for specific restorative codes.

 

Rural Dental Student Loan repayment program

In 2017 and 2018, the GDA secured funding in the state budget to support 12 slots in the program, which provides $25,000/year for up to 4 years in loan repayment assistance from the state for dentists practicing in rural/underserved areas who treat Medicaid patients. In the 2019 session, the Georgia General Assembly added 3 more slots for a total of 15.

Follow this link for more updates on GDA 2019 legislation in the June 2019 Action Journal: https://www.gadental.org/news-publication/action-journal

 

 

*All updates were transcribed directly from State Legislation journals or quotes from State Legislative Correspondence. Thank you to Scott Lofranco (GDA), Phil Latham (SCDA), Valerie Pencook (NCDS), and Laura Givens (VDA) for making this possible.

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