GOVERNMENT RELATIONS
GOVERNMENT RELATIONS
The 2015-2016 legislative session is wrapping up with little fanfare. Having returned to session in late September, and mired down in national, state and local election activities, there were few days left in which to conduct business. All bills introduced, but not passed, this session will“ die” during the sine die period at the end of 2016 and need to be reintroduced next session.
Legislators’ focus for the waning days of this session was on the opioid addition epidemic in Pennsylvania. Dozens of bills were introduced impacting health care providers, prescribers and addicts. They range from continuing education requirements for providers, to limiting the amount of pills providers can prescribe at one time, to establishing more addiction centers around the state. PDA is monitoring all opioid addiction-related legislation and will keep members informed of any new laws or regulations that take effect. providers and insurers, protect providers from unfair insurance practices that impact the financial stability of their practices, and ensures continuity of care for patients.
PDA and other health care provider groups argued that retroactively reviewing and denying payment for treatment previously thought to be covered by patients and providers can financially jeopardize providers’ practices. Over the years, PDA heard that some providers and facilities had to repay insurers thousands, even millions of dollars, for services that were initially approved by the insurer. We also heard reports of patients who cannot afford the cost of dental care or the associated costs to provide such care( such as needing anesthesia) having faced the predicament of owing hundreds, even thousands of dollars for care rendered years prior.
PDA Fights for Restoration of Adult Medical Assistance Benefits
PDA is part of a core group of PA Coalition of Oral Health( PCOH) members discussing how best to lobby for the restoration of adult Medical Assistance benefits in Pennsylvania. In September, this group participated in several meetings with high level officials in the Department of Human Services to discuss a comprehensive benefits package and how much it would cost to cover all eligible adults. PCOH is now scheduling meetings with high level Administration officials to discuss whether funding can be put in the Governor’ s 2017-18 budget proposal. If there is buy-in from the administration, the group will begin educating the legislature, particularly leaders in Appropriations, of the need to restore the adult benefit and adequately reimburse providers.
LEGISLATIVE VICTORY!
PDA took the lead in a broad coalition of health care provider associations lobbying aggressively for this retroactive review legislation to pass.
In the waning days of this session, PDA worked in collaboration with other health care groups to pass legislation limiting the time frame in which insurers may retroactively review and deny claims to 24 months. We are happy to report that the General Assembly passed this legislation in October. Governor Wolf signed HB 2241 into law on November 4. HB 2241, now Act 146, becomes effective in 60 days, on January 3.
PDA believes that passing HB 2241 will help level the playing field between
SPECIAL APPEAL: At a critical time for PDA, help PADPAC reach its goal!
When renewing your PDA membership, please consider becoming a PADPAC donor! PADPAC gives dentists a voice in the public policy arena on behalf of your practice, patients and profession, and is PDA’ s most powerful resource to make a difference in Harrisburg. From the recent reimbursement rate reduction by UCCI to ongoing regulatory issues, PDA continues to confront legislative developments that directly impact the future of how you practice dentistry in Pennsylvania.
It is through PADPAC that PDA directly responds to these legislative developments. Our legislative and regulatory advocacy efforts cannot be accomplished without a well-funded political action committee. After a major election year, it is especially important that we build our hard dollars resources. Hard dollars are contributions made by members with a personal check or credit card. PADPAC’ s hard dollars are used for political campaign contributions. Hard dollars are the foundation of our advocacy work in Harrisburg.
Please consider a personal contribution to PADPAC today! At a time of constant health and regulatory reform, your involvement is more important than ever. To join, visit www. padental. org / padpac or contact Charles McElwee at cfm @ padental. org or( 800) 223-0016.
NOV / DEC 2016 | PENNSYLVANIA DENTAL JOURNAL 7