Government Relations
What else is in the hopper this legislative session ? PDA is monitoring and responding to all of the bills impacting dentistry and dental patients !
Credentialing ( HB 1510 ): Rep . Steve Mentzer introduced legislation on PDA ’ s behalf to streamline the credentialing process for health care practitioners by requiring insurers to use the CQHC system to review and approve standard application forms , requiring insurers to complete the process of credentialing complete applications within 45 days , and assuring that an applicant with more than one practice location is automatically credentialed in all locations once approved .
Medical Loss Ratio ( HB 1415 ): PDA ’ s legislation , introduced by Rep . Kyle Mullins , requires dental insurers to file annual reports with the Pennsylvania Insurance Department of their medical loss ratio ( MLR ) for dentistry . Filing an MLR report is already a requirement under the Affordable Care Act for insurers offering medical health plans . A law establishing a reporting requirement on an MLR for dentistry — the percentage of revenue from premiums spent on patient care — would enhance transparency for patients seeking oral health care and make dental insurers more accountable . This legislation ensures that the Commonwealth has a mechanism to obtain this information from dental insurers and make it accessible to the public .
Teledentistry ( HB 1585 ): On October 18 , the House Health Committee voted on HB 1585 , legislation that defines teledentistry and requires insurance payment for teledental services . The State Board of Dentistry is tasked with further regulating teledentistry to ensure that standards of care are met . Voting HB 1585 out of committee is the first step in the legislative process . PDA ’ s lobbyists , staff , and volunteer leaders will continue to monitor developments and engage with lawmakers as HB 1585 moves through the House of Representatives .
PHDHPs conducting school dental screenings ( HB 1478 ): On October 17 , the House Education Committee voted in support of legislation that amends the Commonwealth ’ s Public School Code to allow public health dental hygiene practitioners ( PHDHPs ) to provide screenings in the school setting to children in kindergarten , third and seventh grades . Section 1403 of the Public School Code only allows schools to employ a school dentist to examine or certified dental hygienist ( who require a dentist ’ s indirect supervision ) to screen children in schools . HB 1478 would give schools more flexibility to contract with PHDHPs who have permits to provide hygiene services in public settings without a dentist ’ s supervision . This legislation has the potential to alleviate the burden many school districts have in finding a dentist or certified dental hygienist to fulfill the Commonwealth ’ s mandate for screenings of children in the school setting .
Medicaid coverage for adults ( HB 1417 ): On October 18 , the House Health Committee voted in support of HB 1417 , which requires a restoration of comprehensive dental services for adult Medicaid patients and for the General Assembly to appropriate enough funds to cover those services . HB 1417 also calls for the elimination of the Benefit Limit Exception ( BLE ) process in HB 1417 . When services were reduced in 2011 , the former Department of Public Welfare instituted this process to provide more services to patients with a serious illness or chronic health condition . A small percentage of Benefit Limit Exception ( BLE ) requests are approved , denying coverage to patients who need more comprehensive dental services to avoid worsening their health condition . The BLE process , flawed from its inception , will no longer be needed with a restoration of adult services . PDA will continue to engage with legislative and appropriation leaders as this bill moves through the legislature .
Dentist and dental hygienist licensing compact ( HB 1586 ): Rep . Kyle Mullins introduced legislation that would make Pennsylvania one of the states participating in the Dental and Dental Hygienist Compact developed in collaboration with the Council on State Governments ( CSG ), the National Center for Interstate Compacts ( NCIC ), the Department of Defense ( DOD ), the American Dental Association ( ADA ), and other stakeholder groups . The Compact creates an alternative pathway to licensure designed to increase mobility and the ability for dentists and hygienists to practice in multiple states .
10 NOVEMBER / DECEMBER 2023 | PENNSYLVANIA DENTAL JOURNAL