Our Two Issues :
Assignment of Benefits ( SB 520 ):
Sen . Kim Ward ( R – Westmoreland ) introduced SB 520 , which would require insurers to directly assign payment to non-participating providers , eliminating financial and administrative burdens for both patients and dentists . In Pennsylvania , patients may not be able to choose their dentist based on preference because some insurance companies do not directly pay the non-participating provider and they might not be able to pay for services in advance . Dentists who do not require advance payment may never be paid for services rendered . This insurance practice unfairly inhibits patients from seeking care from their provider of choice , even though they are paying for a benefit that should be , and can be , applied to any provider , regardless of his or her participation in the patient ’ s insurance plan . The dentist is also impacted because they often sympathize with patients and don ’ t require payment upfront .
By enacting assignment of benefits legislation , Pennsylvania would join 27 states in ensuring that benefit plans are treated as purchased products belonging to the patients . This would help alleviate problems some patients face based on remote geography and situations like divorce or separation . By requiring insurance companies to directly pay dental providers for a patient ’ s treatment , SB 520 will give these patients , not the carrier , the right to decide where to direct their benefits .
SB 520 resides in the Senate Banking and Insurance Committee for first consideration . After Day on the Hill , PDA representatives participated in a series of meetings with Chairman Don White ( R-Armstrong ) and representatives from the insurance Industry to ascertain whether a consensus could be reached on the bill . PDA rejected all of the insurers ’ proposed amendments to weaken SB 520 while continuing to ask Sen . White to place the bill on his committee ’ s calendar for a vote . The carriers ’ continue their strong opposition to SB 520 .
Restoring funding in the DDS program ( SB 290 and HB 1446 ):
In 2009 , the state cut its funding for Pennsylvania ’ s Donated Dental Services ( DDS ) program . This program recruited volunteer dentists and dental laboratories to provide services free of charge to Pennsylvanians who are disabled , elderly and / or medically compromised , who are ineligible for public assistance but still unable to afford the cost of dental care . Many of these patients cannot be treated for more serious illnesses due to their dental problems .
This funding was used by Dental Lifeline Network to employ two regional coordinators who managed the program and facilitated between patients and dentists and dental labs . Since the state cut its $ 150,000 in funding , Dental Lifeline Network has operated the program on a shoestring budget but indicated that it could not sustain the program by itself for too much longer . Dental Lifeline Network is only able to employ one coordinator who works remotely from another state . With only one coordinator , some counties have extensive waiting lists or are no longer accepting new patients into the program .
A reinstatement of funding would give Dental Lifeline Network the opportunity to rehire the second coordinator to facilitate the program , thereby improving access to care for those in need .
After Day on the Hill , PDA secured tentative commitments from appropriation leaders to restore the $ 150,000 in state funding . And in late June , PDA received good news that the legislature restored funding in the Department of Health ’ s budget to run the program . We extend a heartfelt thank you to all of you who attended Day on the Hill .
Your efforts to improve access to care paid off !
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