Advocacy Update

Steve Neidlinger, CAE

There’s really not much going on in capitol buildings these days, the occasional coup d’etat notwithstanding. But much like the first crocus emerging from the unfrozen ground reaching for that first glimpse of sun, or the robin redbreast frustrated with scraps of winter finding that first juicy worm to feed the family, so too are legislative aides reaching out to the Chief Clerk’s office with legislation in hand, looking for that warm feeling of cosponsorship.

Pennsylvania legislation works similarly to Monopoly insofar that if you don’t get it passed in this two-year term, you have to go back to start all over again at the legislative equivalent of Mediterranean Avenue. So most of the bills that PAGD is seeing introduced are retreads from the 2019/20 session. But that doesn’t mean that there aren’t some new issues with a spicy post-shutdown flavor that will work their way onto our delicate palates.

Here’s what we have seen and expect to see so far:

Balance Billing – There is a constant stirring on both the Republican and Democratic sides of the aisle regarding balance billing. Anyone who has ever had the misfortune of a ride in an ambulance or a sudden surgery can attest to seeing an eye-popping number on your Explanation of Benefits. Well, imagine getting that number on your bill from the hospital. What’s the first thing you do? Call your Senator.

The prohibition against balance billing for uninsured services has long been a prominent constituent complaint in the past, deservedly so as it has led to many a personal bankruptcy and financial ruin. The most egregious cases are found in emergency services, but that doesn’t mean dentists won’t get added to the stew. Many trees will needlessly perish to necessitate the paper required for the myriad bills that get printed on this subject. Keen eyes will be reviewing each of these bills to see if their specialty or profession will get roped in.

Telemedicine/Teledentistry – Telemedicine has been on the legislative agenda for years now but has always been bogged down by valence issues that are at best a third cousin to telemedicine. The cacophony of 2020 has cast a light on telemedicine and teledentistry. Many providers and insurers are already offering the service in whatever manner they feel would work best. That maddening inconsistency is forcing legislators and regulators to take notice.

PAGD’s Advocacy Committee, with the help of AGD’s Government Relations Department, has already reviewed and commented on dentistry-specific legislation on the subject. The goal is to ensure that teledentistry is an alternative that can be employed by smart Pennsylvania practitioners to minimize unnecessary patient contact, without providing an avenue for out-of-state docs to hock their wares, or purporting the illusion that teledentistry is on the same quality level of wet-finger dentistry.

Assignment of Benefits – The year was 2002. Hobbits ruled movie screens, Justin and Britney were still an item, and Sanyo turned out the first cell phone that had a camera on it. Meanwhile, at PDA, a fresh-faced 26-year-old named Steve started an all-too-brief tenure in the government relations department. What was on the legislative wish list in 2002? Legislation that would allow patients to assign PPO benefits directly to out-of-network providers.

It’s still there.

Assignment of Benefits legislation would relieve patients of the burden of paying up front or going through the collections process when seeing an out-of-network doc. It has been close to the finish line a few times, but recently has been bogged down with the aforementioned balance billing prohibitions, which would make the cure worse than the disease. The goal for 2021, just as it has been for the last nineteen years, is to see it through both chambers, and have it come out as clean as possible.

In addition, here are some of the other legislation that PAGD is monitoring:

  • House Bill 325 would allow licensing boards the freedom to provide advisory opinions without the crushing reality of a potential lawsuit resulting. Is that a good thing? I guess it depends on the advisory opinion they give you.
  • House Bill 466 would forgive student loans for practitioners that agree to practice in underserved areas. Now if we only had graduates with exorbitant loan burdens.
  • House Resolution 68 would direct the Legislative Budget and Finance Committee to study dental access in rural areas and provide options for improvement. Meanwhile, dental stakeholder groups who think and read about these issues nonstop are throwing their hands in the air like nerds in the back row of a fourth-grade classroom.

Over 2,000 bills are introduced in a two-year legislative cycle, and PAGD is reviewing them all to pick out the ones that would be of greatest interest to general practitioner dentists. See one that we missed? Let me know, the eye in the sky can cover a lot of ground.