Government Relations
Legislative Update
The General Assembly will soon wrap up its spring session and legislators will return to their district for the summer until session resumes in September . The legislature passed its budget for FY 2021-22 in late June , using an influx of federal funds to mitigate the financial shortfalls that were exacerbated by the pandemic .
At the start of session in early 2021 , PDA ’ s lobbyists , staff and volunteer leaders were busy laying the groundwork for several of PDA ’ s legislative priorities , including assignment of benefits and granting full authorization for dentists to administer vaccines . We have also been busy monitoring and responding to other legislation that could potentially impact the dental community .
Assignment of Benefits
Assignment of benefits is PDA ’ s No . 1 priority this session , and we are changing up our strategy to pass it through the General Assembly . This legislation requires insurers to honor patients ’ requests to directly assign their dental benefit to the dentist who renders care , even if the dentist is a non-participating provider .
Sen . Judy Ward is sponsoring this legislation on PDA ’ s behalf . We are working hard to educate senators , particularly those who serve on the Banking and Insurance Committee , about how assignment of benefits legislation will help dentists and patients , and ultimately improve access to dental care .
But we need momentum at the grassroots level so that legislators truly understand how important this issue is to dentists and patients . It hurts our cause when they tell PDA ’ s lobbyists that they have yet to hear from a single dentist about the issue , and it is that much more difficult to counter the insurance lobbyists and convince them that this issue really is important to you and your patients .
Please call your state senator and request support for Sen . Ward ’ s assignment of benefits bill .
You can find your legislator ’ s contact information on the General Assembly ’ s website at : https :// www . legis . state . pa . us / cfdocs / legis / home / findyourlegislator /# address . Type in your home address in the box on the left-hand side of the screen and that will link you to your senator and his / her contact information . Or contact PDA ’ s government relations staff at jpb @ padental . org , and we will look up that information for you .
Talking points in support of assignment of benefits : AoB legislation : 3 Gives patients freedom to choose 3 Enhances the portability of patients ’ dental benefits
3 Improves access to dental care from providers who patients are unable to see
AoB puts the power in patients ’, not insurers ’, hands . It does not force patients to see a non-participating provider , but it will help those patients who wish to do so without having to pay for services upfront .
AoB will not destroy provider networks . Twenty-three other states have enacted similar legislation with no decrease in networks . There is no evidence to support insurers ’ claims that AoB will weaken provider networks .
AoB will help maintain or reduce costs for patients . Of the 23 states with similar laws , there is no data illustrating increased cost to patients . A study from the Indiana Health Law Review found that assignment of benefits laws eliminates many of the administrative hassles associated with billing and payment experienced by both providers and patients .
There is no surprise billing in dentistry . Patients know in advance whether their dentist is a participating provider and that they can choose between receiving care from that dentist or seeking treatment from one who does participate with their plan . Patients receiving dental care from non-participating providers are not surprised by unexpected bills after treatment is rendered . The cost of treatment and an agreement to pay the remaining balance are worked out in advance .
Teledentistry
PDA is monitoring and responding to several telehealth bills that have so far been introduced this session . These bills regulate the practice of telehealth services and mandate insurance payment . Practically speaking , most insurers have already taken advantage of the fact that Pennsylvania does not have a law that expressly prohibits the practice of telehealth and they were already covering some services even prior to the pandemic . A law would further define telehealth and third-party payment processes , and it would also provide more guidance to licensing boards promulgating regulations for their respective licensees who are engaging in telehealth services .
MAY / JUNE 2021 | PENNSYLVANIA DENTAL JOURNAL 7