G ove r n men t Re lat ions
Legislative Action Alert: Schedule an appointment with your
representative over the holiday break!
Your state lawmakers are home until mid-January. It’s the
perfect time to schedule an appointment or make a phone
call to discuss HB 564, PDA’s legislation requiring insurers to
directly pay non-participating providers. Use the talking
points below to keep consistent our message to legislators.
Don’t’ forget to call or email the government relations staff
to let us know how your legislator responded
HB 564 TALKING POINTS
PDA thanks Rep. Stan Saylor for introducing legislation to
provide dental patients with more control over their oral
health care. HB 564 would require insurers to assign benefits
(on patient’s request) to dentists, regardless of whether
they participate with the insurer. It is my understanding that
Sen. White may soon schedule a Banking and Insurance
Committee vote on SB 373.
HB 564 will drive down health care costs by simplifying the
payment and reimbursement process for patients and health
care providers.
REASONS TO SUPPORT HB 564
Insurance companies oppose assignment of benefits laws
because they feel this will weaken the participant network.
Empirical evidence does not substantiate the claim that
provider networks are weakened in states with assignment
of benefits laws. Most recently, a study from Florida after it
enacted assignment of benefits legislation found no net loss
in physicians’ participation in network plans.
Assignment of benefits legislation would eliminate financial
and administrative burdens for both patients and dentists,
and ensure timely care. By enacting assignment of benefits
legislation, Pennsylvania would join 23 other states in ensuring
that benefit plans are treated as purchased products
belonging to the patient.
Directly paying patients’ provider of choice will eliminate
financial and administrative burdens for both patients and
dentists, and ensure timely care. Passage of HB 564 as
amended will give all patients the fundamental freedom to
be treated by the dentist of their choice.
Some patients cannot see their dentist of choice because
some insurance companies do not directly pay the non-
participating provider, and the patient cannot afford to pay
for services upfront. This insurance practice unfairly inhibits
patients from seeking care from their dentist of choice, even
though they are paying for a benefit that should be able to
be applied to any provider, regardless of whether or not the
provider participates with the insurance plan.
Parents who are divorced or separated may experience the
problem where one parent has custody of a child, while the
other parent carries the insurance. The latter may never send
the insurance check to the custodial parent, who had to pay
for services upfront. Faced with this situation, many custodial
parents postpone or avoid care altogether.
Patients residing in rural areas are placed at a disadvantage
as there may only be a handful of dentists who are in-
network. Patients may have to incur more traveling time and
expense to seek treatment from an in-network provider,
rather than being treated by a non-participating dentist who
practices in closer proximity.
Save the Date!
THE ADA’S DENTIST AND STUDENT LOBBY DAY IS SCHEDULED FOR APRIL 26-28, 2020, IN WASHINGTON D.C.
Join hundreds of your colleagues and dental students from across the nation to lobby Congress on a number of issues
important to your profession and your patients!
PDA has some funding available to assist members who attend this event and visit with the Pennsylvania Congressional
delegation.
Stay tuned for more information. Registration and hotel reservations will open in January.
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NOV E M B E R/DE CE M BER 2019 | P EN N S YLVA N IA D EN TA L J O UR NAL