G ove r n men t Re lat ions
The Pennsylvania General Assembly adjourned in December
without having moved PDA’s prime legislation (Assignment of
Benefits), which would require insurers to assign benefits directly
to non-participating providers, upon patients’ request.
There are other bills pending in the House of Representatives and
Senate that PDA is tracking and responding to on your behalf.
They run the gamut of opioid prescriptive authority, telemedicine,
licensing and the roles of the dental workforce, to name a few.
2019 Legislative Recap
HB 564: Assignment of Benefits legislation
In June 2019, PDA met with Rep. Tina Pickett and her chief of
staff to discuss moving HB 564 out of committee. They presented
PDA with the idea that a law already exists that requires insurers
to directly pay all providers, even those who do not participate with
the insurers’ plans.
PDA considered a proposal to “strip” the assignment of benefits
language in HB 564 to instead include language from Act 68 of
1999, which requires insurers to promptly pay clean claims
submitted by participating providers within 45 days. All parties
agreed that the best course of action was to strip HB 564 to
include language to clarify that the intent of Act 68 was to make
insurers directly pay clean claims to non-participating providers,
and that PDA should lobby to have the House Insurance
Committee vote on this amended version before the budget
passed at the end of June. This was the only way to move the bill
out of committee before the summer recess. The House Insurance
Committee voted HB 564 out of committee on June 27; the
Republicans voting “yes” and the Democrats voting “no.”
HB 564 moved to the House Appropriations Committee, which is
chaired by the prime sponsor. PDA is currently engaged in
discussions with House leadership to schedule the bill on the
calendar. Leadership has expressed that the bill would fare better
by reverting back to the original assignment of benefits language.
At the time of this report, the strategy moving forward is for
the House Appropriations Committee to vote to revert HB 564
back to the original assignment of benefits language.
N OVEM BER/DECEM BER 2019 | P EN N SYLVAN IA DEN TAL JOURNAL
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