legislative
PDA Advocates on Members Behalf
PDA’s Bill Prohibiting Caps on Non-Covered Services Passes
General Assembly:
PDA made passing legislation prohibiting insurers from capping non-covered dental services
a top legislative goal in recent years. Understanding the financial impact this policy had on
those members participating with insurance companies, PDA’s lobbyists, staff and volunteer
members met continuously with lawmakers and the Governor’s Administration. These
collective efforts paid off when Gov. Corbett enacted PDA’s bill in October 2012. This new law
now prohibits insurers from limiting the amount a dentist can charge for non-covered
services. The bill will apply to new and renewed employer contracts.
PDA Meeting with United Concordia Results in a Decrease in Claim
Denials for Some Procedures
PDA met with the insurer in 2015 to discuss the increase in denials of claims for restorations,
crowns, and scaling and root planning. United Concordia acknowledged that some of
its reviews were interpreting the guidelines too literally and agreed that they needed more
guidance on claims processing. UCCI later reported a 30 percent reduction in claims denial
since meeting with PDA.
PDA Wins Fight for General Anesthesia Coverage for At-Risk Patients
PDA strongly lobbied for legislation that requires all insurers to cover under their medical poli-
cies the costs associated with administering general anesthesia to children seven years of
age and younger and patients with developmental disabilities. This law, which took effect in
2012, requires medical plans to pay for hospitalization and related medical expenses, such
as the administration of general anesthesia, when dental treatment must be performed in
hospitals. Not providing this coverage limits access to care for those patients who require ex-
tensive dental work and need general anesthesia because of behavior management issues
or have special needs.
For more information, visit the PDA Advocacy website