Legislative Affairs

 

Grassroots Network

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The goal of the MDS Grassroots Network is to ensure that every legislator has the most accurate information about dentistry and oral health in the Commonwealth.

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Check out recent testim-onies submitted by MDS about legislation under consideration at legislative hearings.

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Check the MDS Calendar for council, committee, CE, and district meetings.

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Prescription Monitoring Program Utilization Requirement

Last year, the Massachusetts legislature passed a law requiring dentists to access the Prescription Monitoring Program (PMP) prior to seeing a patient for the first time. The Department of Public Health subsequently released draft regulations based on this law that would have required a dentist to comply with the requirement with a limited set of exceptions. The MDS continues to work with both lawmakers and regulators to craft a more common sense approach to limiting curbing the abuse of prescription drugs in the Commonwealth. Please follow the links below to read more about these efforts.

2013-2014 Issue Papers

Preventing Cost Shifting Within the Delivery of Dental Care

The MDS wants to ensure that dental benefits companies do not unfairly shift costs to patients and dental practices by setting fees for services for which they do not pay providers. An Act Relative to Financial Services Contracts for Dental Benefits Corporations adds Massachusetts to the rank of 30 states that have outlawed such practices.

It Isn't the Right Issue, the Right Time, or the Right Model: Massachusetts Does Not Need ADHP

The MDS has worked closely with the Legislature and MassHealth to expand access to care, most recently doubling the number of its members who participate in the MassHealth Program in just four years. The MDS supports ongoing efforts to increase access to dental care, but strongly opposes legislation creating an ADHP level of practice.

Creating More Opportunities for Patient Choice in Dental Care

Patients have the right to choose where they receive dental care. Patients who choose to receive care from an out-of-network provider should not be required to be financially liable for payment while awaiting reimbursement from their dental benefits company. Instead, Massachusetts should join 23 other states in allowing patients to assign the benefits of their coverage directly to their providing dentist.

Ending Unlimited Recovery on Faultless Mistakes

Companies offering dental benefits in Massachusetts should not be allowed to indefinitely hold others responsible for their administrative mistakes. Under current law, a benefits company is afforded an unlimited time period in which it may retroactively deny a paid claim. This effectively allows the dental benefits company to shift the losses associated with its own administrative mistakes onto the care provider.

Protecting the Most Vulnerable and Ensuring Coverage of Needed Care

Young children and persons with special health conditions have greater difficulty undergoing long dental procedures.  For this reason, hospitalization and general anesthesia are often necessary for these patients to receive proper and safe dental treatment. Unfortunately, many of these patients are forced to delay, compromise, or forgo treatment because their families cannot afford hospital and anesthesia fees.

Oral Health/Overall Health: Ensuring that School Children Have a Dental Exam

We owe it to our children to ensure that they have good oral health. Dental disease is the most common chronic childhood disease—five times more common than asthma and seven times more common than hay fever. Students receive physical examinations, required vaccinations, and vision and hearing tests. Children should also have a dental exam before entering the classroom to ensure a lifetime of good oral health.

Understanding Oral Injuries in Youth Sports

The National Youth Sports Safety Foundation recorded that more than 5 million teeth are knocked out in sporting activities. The costs associated with treating sports-related oral injuries are staggering—replacing a single tooth and seeking follow-up care can cost up to $5,000. Yet only an estimated 7 percent of youth sports participants are required to wear mouthguards all or some of the time.

Governor Patrick's FY14 Budget Proposals

On Wednesday, January 23, 2013, Governor Deval Patrick submitted his fiscal year 2014 budget proposal to the legislature. Click here to access the Governor's budget website. While the Governor's budget is just the first step in a long process, it does serve as the foundation for discussions leading up to the releases of the House (April) and Senate (May) budgets.  As the media has reported, the Governor's proposal contains many revenue-generating measures, including expanding the sales tax to include candy and soda and increasing the taxes on cigarettes and chewing tobacco. In addition to these proposals, the Governor also addressed two areas of particular interest to dentists:

 

MassHealth Adult Dental Coverage

In his "Issues in Brief" communication to legislators that accompanied his budget, Governor Patrick stated that, "The Centers for Medicare and Medicaid Services [CMS] has indicated that a 50 percent federal match will be available in FY 2014 for premium assistance payments for State Wrap members, with the exclusion of [Aliens With Special Status], making available an additional $21 million in available revenue. This revenue, combined with the enhanced [federal financial participation] available through the [Affordable Care Act], will enable the restoration of full adult dental coverage for MassHealth members..." 

 

In short, additional federal funds will be available when various provisions in the Affordable Care Act kick in at the beginning of 2014. As a result, language in the Governor's budget allows the Executive Office of Health and Human Services (EOHHS) the discretion to continue to limit the MassHealth adult dental benefit, but only until December 31, 2013. After that date, EOHHS must restore coverage to the same level as was available in 2002. Click here to read the Governor's "Issues in Brief: Expanding Access to Affordable, Quality Health Care." 

 

Study Commission on Dental Insurance

Governor Patrick sent a letter to the legislature explaining his pocket veto of our non-covered services legislation in which he promised to include a special commission on dental insurance in his budget. Outside Section 30 of  his budget states, "There shall be a special commission on dental insurance. The commission shall review carrier contracts with dental providers and the methods by which dental providers are reimbursed for services provided to persons covered under the carriers' dental plans. The commission shall study all facets of fees charged by dentists within network plans, including those limited by the terms of a dentist's contract with carriers..." The MDS leadership is currently reviewing the Governor's proposal.

 

Please continue to check this page for updates as we move through the budget process.

 

Go to the Governor's Budget page

 

2013-2014 Legislative Agenda

An Act Relative to Financial Service Contracts for Dental Benefits Companies

Sponsors: Senator Harriette Chandler and Representative John Scibak. This bill requires that a contract between a dentist and a dental benefits company cannot mandate that the dentists provide dental services to a covered person at a particular fee unless those services are services for which the dental benefits company provides payment.

An Act Relative to Increasing Choice for Dental Patients

Sponsors: Senator Harriette Chandler and Representative John Scibak. This bill allows patients to assign their benefits to a dental provider. Currently, a patient with dental benefits who sees a provider who does not participate in that benefit plan must pay the provider out of pocket and then seek reimbursement from the benefits company.  

An Act to Limit Retroactive Denials for Dental Insurance Claims

Sponsors: Senator Harriette Chandler and Representative John Scibak. This bill limits the period of time during which a dental benefits company may retroactively deny a claim. It sets a one year maximum for such a denial.

An Act Relative to Pupil Dental Health

Sponsor: Representative Sean Garballey. This bill requires that children receive a dental exam within 12 months of entering school. The state will be required to create a standardized notification form and collect the data from that form in a centralized and accessible database. Parents will be able to opt-out of the exam for a series of reasons enumerated in the bill.

An Act to Conduct a Comprehensive Study of Oral Injuries in School Sports

Sponsor: Senator Cynthia Stone Creem. This bill directs the department of public health to conduct a comprehensive study of oral injuries in schools for the purpose of reducing oral injuries in youth sports.

An Act Relative to Anesthesia Coverage for Children Hospitalized for Dental Treatment

Sponsor: Representative Kay Khan. This bill requires health care plans to provide coverage for anesthesia and outpatient treatment for dental care for children with disabilities, certain medical conditions, and all children under the age of 6.

Coverage for Cleft Palate/Cleft Lip Now Mandated

On August 6, Governor Deval Patrick signed H3928—An Act Relative to the Treatment of Cleft Palate and Cleft Lip into law.  The bill requires that health insurance carriers cover the treatment of cleft palate and cleft lip. Specifically, "The coverage shall include benefits for medical, dental, oral and facial surgery, surgical management and follow-up care by oral and plastic surgeons, orthodontic treatment and management, preventative and restorative dentistry to ensure good health and adequate dental structures for orthodontic treatment or prosthetic management therapy, speech therapy, audiology, and nutrition services, only if such services are prescribed by the treating physician or surgeon and such physician or surgeon certifies that such services are medically necessary and consequent to the treatment of the cleft lip or palate.  The coverage required by this section is subject to the terms and conditions applicable to other benefits. Payment for dental or orthodontic treatment not related to the management of the congenital condition of cleft lip and cleft palate shall not be covered under this provision."  Please contact MDS Director of Governmental Affairs David White if you have any questions.

Read the Full Bill

2011-2012 Formal Sessions Wrap-Up

On July 31, 2012, the Massachusetts General Court met in formal sessions for the last time this year. While the legislature will continue to meet in informal sessions until January, this is a great opportunity to summarize several important actions:

Non-covered Services Bill: Our non-covered services bill advanced through three jurisdictional committees—the Joint Committees on Financial Services and Health Care Financing and House Ways & Means—before being sent for a third reading. While we would have liked to have seen the bill enacted before the end of formal sessions, unfortunately, the clock ran out before we were able to accomplish that goal. We do still have the opportunity to move the bill during informal sessions between now and January. Please stay tuned for more information.

 

Grassroots Advocacy: The performance of our grassroots network during this session has been nothing short of spectacular. In the last two weeks of formal sessions, 89 of the 160 members of the House and 36 of the 40 members of the Senate heard from dentists from their districts about our non-covered services bill. Many legislators received a high number of calls, including Chairman Dempsey of House Ways & Means. We should all be very proud of these results and we thank those dentists who responded to our Calls to Action.

 

Hygienists on BORID: the Massachusetts Dental Hygienists Association filed a bill that would have given them a standing subcommittee of BORID that would have had virtually independent oversight of all regulation and discipline of dental hygienists. Through the legislative process, the bill was amended to only include one additional dental hygienist as a voting member of BORID for a total of 2, in addition to the 6 dentists, 2 public members, and 1 dental assistant who currently serve as voting members. While the bill did advance in the Senate, it stalled in the House. We will continue to monitor this bill during informal sessions.

 

Prescription Drug Bill: The Senate fast-tracked legislation that would have required prescribers (including dentists) to scan patient histories in the Prescription Monitoring Program (PMP) before issuing certain prescriptions. The original bill would have also limited dentists to prescribing an arbitrarily limited number of pills. We were successful in getting several changes in the Senate, including the removal of the limitation in favor of a commission that would make recommendations on appropriate prescribing practices (MDS would have a seat on that commission). The House took up the bill in the final hours of the session and made even more changes. Their version automatically enrolls prescribers in the PMP when they renew their license to prescribe and instructs the Department of Public Health to work with the licensing boards (i.e., BORID) to develop regulations on when a prescriber must review the patient's PMP record prior to prescribing. The House and Senate have worked out their differences and Gov. Patrick has signed the bill into law.  Click here to read a comprehensive analysis of the bill.

 

Payment Reform: The House and Senate enacted payment reform legislation that the Governor has signed. The bill is 349 pages long and contains plenty of changes that we will be monitoring that do not directly impact dentists at this time.  One provision that will have an immediate impact on dentists involves malpractice reform. The bill creates a 182-day cooling off period to negotiate a settlement before litigation can commence. It also allows providers to apologize for a mistake without that apology being used in court as an admission of liability, and creates a commission to look at defensive medicine. These are positive developments for dentists.

 

We still have more to do. We will continue to use our grassroots strength to try and move our non-covered services bill during informal session. Please stay tuned for more details!


  
  

 


Volunteer Dental License Bill Signed by Governor Patrick

The MDS is pleased to announce that legislation on volunteer dentistry (S.2567 An Act Relative to Certain Temporary Registrations and Volunteer Dentistry) was signed by Governor Deval Patrick on August 7, 2010. This bill allows retired dentists who are willing to provide care at no cost in free care clinics to qualify for a volunteer dental license. The bill also allows dentists from outside of Massachusetts to receive a volunteer dental license to travel to the Commonwealth for educational or teaching purposes.