This week has been an extremely busy week for MDA lobbyists as they worked around the clock on behalf of Minnesota’s dentists. First and foremost, the MDA bill that relates to non-covered services was brought back to life. In a late night hearing at the Capitol, the MDA language was amended onto the House’s Omnibus Health and Human Services bill.
As we had mentioned in previous alerts, a national trend has emerged where insurers are capping dentists’ fees for services not covered by the dental benefit plan. This policy sets a cap on the amount that a dentist can bill a patient for services not covered by the plan, thus setting a maximum allowable fee on non-covered services. “Not covered” should mean what it says - it is outside of the scope of the contract between the employer and the insurer and is none of the insurance company’s business. It should be an arrangement strictly between you and your patient.
The MDA opposes such limitations and this legislation would prevent insurers from capping fees for non-covered services. Our bill was originally supported by Delta Dental Plan of Minnesota. However, non-Minnesota based dental third-party payers, claiming a competitive disadvantage to Delta’s market share, were successful in excluding themselves from the legislation.
We still have a long ways to go, however, if this legislation is to pass. Delta is now opposed to it because it only impacts them. Some legislators, along with the MDA, are concerned that it does not go far enough to cover all payers. There are also a few legislators who have labeled it “anti-consumer." The anti-consumer argument was a key reason the MDA bill was originally defeated in a Senate committee.
While our language is contained in the House HHS bill, it is not in the Senate version. There may be a challenge to it on the floor of the House and debate in conference committee as to whether the language stays or not. We also have to consider that the omnibus HHS bill may be vetoed.
We will keep you apprised of this situation. In the meantime, we encourage you to contact your legislators and urge them to support the non-covered services language titled “Contracts With Dental Care Providers” in the Omnibus HHS bill.
Here is a list of some other key legislative items the Minnesota Dental Association has been working on this week.
Critical Access Dental Provider Program: The Governor unalloted $6.2 million in 2009 and has proposed cutting another $3 million this year from this program that increases dental reimbursements for dentists who see substantial numbers of public program patients. Despite a huge state budget deficit, we have been working to restore these cuts in order to maintain private and non-profit safety net dental clinics. With the release of both the House and Senate HHS bills this week, we are proud to report that the program will likely continue to be funded. Exactly how dental clinics will qualify still needs to be worked out as both bills take different approaches.
Critical Access Dental Provider Program Eligibility: The Minnesota Department of Human Services maintains there is substantial “fraud” amongst dentists seeing low-income patients under the critical access program and, as a result, is seeking authority to dismiss dental clinics from the critical access program, including the right to use dental plan audit findings for such dismissals. We have been working with legislators to ensure that this language is acceptable and that the Department uses a fair process in determining eligibility. Both the House and Senate bills contain our recommendations; however, we are still working to further limit the Department’s use of unfair eligibility requirements and we ultimately prefer that no such language be passed.
Adult Dental Benefit Set: Minnesota has always provided a comprehensive dental benefit set for public program adults. Due to budget shortfalls, the adult dental benefit set was restricted substantially by the legislature in 2009. The MDA created a video with the assistance of ADA State Public Affairs financing that has helped to illustrate the problems created by a partial benefit set and that has convinced many legislators that some dental benefits need to be restored. We are pleased to report that we have successfully lobbied the House to restore or increase the frequency of coverage for full-mouth radiographs, molar root canals, relines and repairs of dentures, adding teeth and clasps to dentures, limited periodontal scaling and root planning, and some general anesthesia.
There are two things to keep in mind, however. First, while these procedures may be brought back, the dental benefit set for adults will remain quite limited. Second, these adult dental benefit set suggestions are not included in the Senate bill. There is much work to be done before final passage.
State Operated Dental Clinics: The state operates five dental clinics that serve developmentally disabled patients. As part of a budget cutting plan, the Minnesota Department of Human Services has proposed closing those clinics. The MDA was successful this week in fighting to prevent these developmentally disabled patients from being abandoned -- both the House and Senate bills will restore the funding for these dental clinics and will prevent the state from closing them. In addition, the House bill would establish an advisory group made up of a variety of stakeholders, including the MDA, to recommend how these services could be provided more efficiently in the future.
Donated Dental Services (DDS) Program: The Governor had proposed eliminating funding for the DDS Program. The MDA successfully fought to maintain DDS Program funding in both the House and Senate bills, arguing that for every state dollar spent $15 of free dental care is provided by dentists to very needy patients.
There are just over two weeks left before the legislature adjourns and there is still much work to be done. The omnibus bills need to pass out of a number of committees and their respective legislative bodies. Then they will go to a conference committee where all bets are off and anything can happen. Please keep an eye out for future legislative alerts from the MDA and be prepared to act on them immediately.