Virtual TDA Legislative Day
Wednesday, February 17, 2021
Due to COVID-19 restrictions largely closing the Texas Capitol to the public, it will be held virtually this year. More information on virtual meetings with legislative offices will be forthcoming.
Three of the TDA’s top legislative priorities include teledentistry as a COVID response effort to ensure patients may be safely treated via technology, insurance reform to maintain fairness and disclosure, and budget protection for the benefit of educating students, treating those on Medicaid, and regulating the profession. Following are detailed bullet points on those issues:
- Many Texas dentists currently utilize technology to care for their patients. If existing standards of care are strictly met, the TDA supports using technology to provide care to patients.
- As directed by the House of Delegates, the TDA will pursue legislation to align dentistry with telehealth and telemedicine, uphold the current standard of care in dentistry, and mandate proper dentist oversight, supervision, and delegation.
- The effort will include defining teledentistry in law to authorize and limit services delivered by a dentist, or a health care professional (dental hygienist, dental assistant) acting under the delegation and supervision of a dentist, within the existing standard of care and scope of their respective license or certification to a patient at a different physical location using telecommunications or information technology.
- Network Leasing/Silent PPO
- Dental insurance can often be confusing for both patients and dentists. This is certainly true with silent preferred provider organizations (PPOs).
- In a silent PPO, the original insurance plan sells or rents its provider network to other payors of dental services such as insurance companies, self-funded plans, or others. Participating dentists routinely have no knowledge of the sale or the rental.
- Contracting dentists must clearly be made aware when an insurance carrier sells or rents its network to other payors.
- The TDA will pursue legislation to mandate that insurance carriers properly notify dentists when the plan they join is sold or rented to another payor.
- Retroactive Denials
- Dental insurers audit their claim payment/adjudication activities before and after payments to ensure accuracy and efficiency. While it is appropriate for insurance carriers to audit payments for errors and adjust accordingly, it is unfair for carriers to expect dentists to refund payments after a significant amount of time has passed before the dental insurer determines that it erroneously paid the dentist.
- The TDA will pursue legislation establishing a process for dental insurance carriers to use if auditing dentist providers that will include a reasonable audit timeframe during which a carrier must complete the audit.
- The legislature must pass a balanced budget every two years. The budget is always a priority and focal point of legislators and stakeholders including the TDA.
- When lawmakers gather in Austin at the beginning of 2021, they will face challenges with the budget they must write for the 2022-23 biennium. The current pandemic has negatively impacted state revenue streams including sales tax and oil and gas severance taxes.
- Specific to dentistry/oral health, state government provides vital funding to the TSBDE, the Medicaid dental program, the dental schools, clinic operations at the dental schools, loan assistance programs, and many other programs that affect dentistry. Many of these programs rely on discretionary funding which will be extremely limited.
- The TDA will work in the 87th session to maintain – and increase where possible – funding levels for these and many other programs that affect dentists and dental patients.