CDA has a dedicated team of professionals whose sole purpose is to advocate for the profession and for patients, working to sponsor new laws improving dentists’ and patients’ rights.
To help give dental students a voice, CDA hosted a Grassroots Advocacy Day at the Capitol with the UCLA School of Dentistry. Five CDA student representatives from the school traveled to CDA’s headquarters on Feb. 12 and spent the day meeting with legislators and touring the Capitol building.
Even with the rollout of the Affordable Care Act (ACA) barely under way, Covered California, the agency charged with implementing the ACA in this state, devoted considerable time last month to planning for expanded dental benefit offerings for 2015. CDA has continued to push for making a variety of plan options available to all consumers, including adults, and the state is now moving in that direction, with many details still to be worked out.
The Medical Injury Compensation Reform Act of 1975 protects dentists and other health care providers from frivolous lawsuits and outrageous malpractice rates that drove many practitioners out of the state. The law is now under attack by trial lawyers who are circulating petitions to force a November ballot initiative, in essence to allow bigger payouts to pad their pockets. CDA President James Stephens, DDS, outlines why dentists need to preserve MICRA and support the fight that CDA and other health care organizations are involved in this year.
The California Dental Association is sponsoring a patient protection bill introduced by Assemblymember Nancy Skinner, (D-Berkeley), to ensure that a minimum percentage of consumer premiums are actually spent on their dental care instead of insurance company overhead and administration costs.
With a new legislative session under way, CDA’s volunteer leaders and its Sacramento advocacy team are simultaneously on offense and defense on a wide range of legislative and regulatory issues impacting dentists and patients across the state. The issues range from dental insurance and malpractice reforms to state oral health policy leadership and regulation of dental hygienists.
There is still much uncertainty regarding the overall and long-term impacts of the Affordable Care Act (ACA) on the health and dental care delivery systems. What we do know, however, is that the ACA will usher in access to dental care for many more children outside of the ACA-created online insurance marketplaces – including coverage through most private health insurance plans.
Jim Wood, DDS, is running for election in the 2nd Assembly District, which covers all or part of Del Norte, Humboldt, Mendocino, Trinity and Sonoma counties. If elected, he would be the only dentist member of the California Legislature. Wood, who has been active in the policy arena with CDA, vows to be a strong advocate for dentistry and health care in the Legislature.
As of Jan. 1, 2014, many of the major reforms created by the Affordable Care Act (ACA) are in place. While the law is lengthy and has many complicated provisions, there are four basic concepts implemented by the law: providing private and public health insurance reforms and patient protections; allowing states to expand Medicaid coverage; requiring U.S. citizens to have health insurance coverage or pay a penalty; and creating marketplaces for health and pediatric dental insurance coverage.
The Dental Board of California recently began a large-scale enforcement effort against the unlicensed practice of dentistry in Southern California. The Southern California Unlicensed Dentistry (SCUD) Task Force was established by the Dental Board's enforcement unit and has been investigating numerous reports of unlicensed dentistry being offered in a wide variety of settings.
In January, dentists receiving their biennial renewal statements from the Dental Board of California (DBC) will see an increase in the total fee from $365 to $377.
The Dental Hygiene Committee of California (DHCC), created via legislation enacted in 2008, will be undergoing its first legislative “sunset review” over the course of the next year. CDA has expressed early concerns about several changes to current law proposed by the committee.
To help members have an impact in their local communities and statewide, CDA has launched a revamped grassroots advocacy program. Under the program, CDA organizes “Advocacy Days” designed specifically for individual components. Groups of approximately five dentists are selected from a component to either come to Sacramento or to take part in a regional advocacy day and meet with legislators in their home districts.
CDA and partners in the coalition, Californians Allied for Patient Protection (CAPP), are preparing for a year-long battle to defeat an effort by trial attorneys to change a provision of a law that protects dentists and other health care providers from frivolous lawsuits.
CDA is working with Covered California staff to identify additional training that needs to be provided to the enrollment specialists to help them better support families in accessing the dental benefits that are available to them. In addition, CDA is providing feedback to Covered California on the short-term, and perhaps longer-term, fixes that need to be made to the website to ensure that families who want to buy the dental coverage through the portal can do so efficiently.
Two new laws regarding data breach notification and information privacy go into effect with the New Year. The first, SB 46, expands the definition of “personal information” that triggers a data breach notification. The other, AB 370, requires disclosure of how a commercial website responds to “do not track” browser signals.
After a rocky first few days following its long-anticipated Oct. 1 opening for enrollment, Covered California, the state health insurance marketplace created by the Affordable Care Act (ACA), has now reported some data on the number of consumers who have been able to access health insurance through the new marketplace. CDA remains actively engaged in all of the ACA’s implementation details and can be a resource to members interested in finding out more about the new law and how it may impact dentists and dentistry.
Jim Wood, DDS, a general dentist in Cloverdale since 1987 and the current vice mayor of his hometown of Healdsburg, has formally launched his campaign for a State Assembly seat in the 2014 election season. If elected, Wood would become the second dentist currently serving in the state Legislature, joining Sen. Bill Emmerson, DDS, of Redlands, whose tenure will be ending due to term limits in 2016.
Gov. Jerry Brown on Oct. 7 signed into law legislation sponsored by CDA that will equalize the state’s regulatory standards governing portable dental practices and mobile dental vans.
On Oct. 1, Delta Dental of California issued a formal Answer to the Demand for Arbitration. Delta asserts that it has the right to amend Participating Dentist Agreements based on language in the contracts and its notification to the Department of Managed Health Care indicating that it intends to revise the provider agreements.
After months of intense preparation, Covered California, the health insurance marketplace created by the Affordable Care Act (ACA), began its open enrollment period on Oct. 1. Consumers can now begin the process of comparing and purchasing affordable medical and dental insurance coverage online, and Covered California is offering in-person and phone support for those who need it.
After nearly a year of consideration by two community advisory commissions, the Berkeley City Council voted 6-3 last week in favor of a resolution that encourages, but does not require, reduced use of dental amalgam and other potential sources of mercury exposure. The final resolution is consistent with CDA’s belief that the decision to use amalgam should remain an informed choice that is made by each individual patient in consultation with his or her dentist.
The 2013 legislative session came to a close without the introduction of legislation backed by trial attorneys to raise the MICRA cap on non-economic damages. CDA and partners in the coalition, Californians Allied for Patient Protection (CAPP), actively worked to communicate to legislators the importance of maintaining current provisions of the Medical Injury Compensation Reform Act, which ensures injured patients receive fair compensation, while stabilizing liability costs.
Gov. Jerry Brown’s administration has announced that it is no longer moving forward with a legislative package to reform the Proposition 65 warning notice and litigation laws. CDA had been the only health care organization invited to participate in stakeholder discussions with the administration on this issue.
The ADA has announced the release of the first set of dental performance measures under the Dental Quality Alliance (DQA). The DQA, comprised of multiple stakeholders from across the oral health community, was created to establish a series of oral health care performance measures.
The lengthy arbitration process between CDA and Delta Dental has commenced, with the parties entering into discussions about the selection of an arbitrator. Delta is expected to file a formal response to the demand for arbitration on or before Oct. 1.
CDA’s legal action challenges both Delta’s right to make certain amendments to dentists’ individual contracts and reduce Premier fees unilaterally. CDA will request that the arbitrator, once appointed, maintain the status quo until a final ruling is made in the binding arbitration.
As the 2013 legislative session drew to a close, CDA’s three sponsored bills were in different stages of completion. One has already been signed by the governor, a second is awaiting his signature and a third is expected to be moved in 2014.
The Affordable Care Act (ACA) amended the federal Fair Labor Standards Act, creating a requirement that employers provide a notice to all employees of the existence of the newly formed insurance marketplace available to them along with information on how to contact the insurance marketplace to request assistance in purchasing coverage if the employee chooses to do so.
CDA’s legal action against Delta Dental of California, filed on Aug. 14, has prompted member questions about the next steps in the process. In order to help members understand the legal action, CDA has prepared a FAQ document. CDA will continue to provide regular updates on developments in the case.
CDA and partners in the coalition, Californians Allied for Patient Protection, are launching statewide efforts to fight an attempt by trial lawyers to make changes to the Medical Injury Compensation Reform Act (MICRA), which ensures injured patients receive fair compensation, while stabilizing liability costs. Trial lawyers have filed a ballot measure with the State Attorney General — the first step in a long and expensive process to qualify a measure for the ballot — which would change provisions of MICRA that protect dentists.
Many dental practices, because of their small size, may not be required to provide FMLA benefits to employees. However, risk management analysts at The Dentists Insurance Company advise dentists to address any request for a leave of absence with caution. There may be other laws that do apply to employee leave, such as the Americans with Disabilities Act or workers’ compensation.
With the legislature entering the final month of its 2013 session, CDA was an active participant in negotiations with the governor’s office, the legislature, and a variety of business, legal and consumer stakeholders in an attempt to improve the state’s Proposition 65 warning notice and litigation laws. Prop. 65 requires businesses with 10 or more employees to provide “clear and reasonable warning” if the product or business location may expose employees or consumers to a chemical known to the state to cause cancer or reproductive toxicity.
On behalf of its members, the California Dental Association — along with several individual dentist providers — has taken legal action against Delta Dental of California by filing a demand for binding arbitration in response to Delta’s notice dated Aug. 1, informing providers of changes to key provisions in their agreements.
California’s Health Benefit Exchange Board, which is tasked with implementing the federal Affordable Care Act in California, held a special meeting on Aug. 8 to focus primarily on issues surrounding the implementation of the pediatric dental Essential Health Benefit. The board upheld its decision to allow only stand-alone dental plans and ruled that it was too close to the date of open enrollment (Oct. 1, 2013) to allow traditional health plans to submit new bids including the pediatric dental benefit at this time. CDA strongly supported the Exchange’s decision to allow stand-alone dental plans.
The law protecting dentists, physicians and other health care providers from frivolous lawsuits is under attack again, and this time trial lawyers threaten to take the issue to voters next year if the Legislature does not make changes to the Medical Injury Compensation Reform Act (MICRA) before the end of the summer legislative session. Legislation has not surfaced yet, but CDA and other partners in the coalition, Californians Allied for Patient Protection, are gearing up to fight efforts to change the law that ensures injured patients receive fair compensation, while stabilizing liability costs.
Covered California, the health and dental insurance online marketplace created by the Affordable Care Act (ACA), has announced the dental plans that will be available for purchase through the Exchange. Six plans were chosen: Anthem Dental; Blue Shield of California; Delta Dental of California; Health Net Dental; LIBERTY Dental Plan; and Premier Access Dental.
Three bills sponsored by CDA are moving through the Legislature. The bills focus on requiring dental plans operating in the California Health Benefit Exchange to abide, for the first time, by several consumer-focused provisions, supporting volunteer care by retired dentists, and increasing state oversight of mobile and portable dental practices.
The California Dental Association applauds the governor’s signature of a new state budget plan that includes the restoration of Adult Denti-Cal services.
Legislation aimed at making sure dental plans put more of their revenues into actual care for patients passed its first legislative hurdle. AB 18 (Pan), championed by CDA, successfully moved through the Assembly Health Committee, overcoming strong objections from dental plans and health plans.
The effort to restore Adult Denti-Cal benefits is one step closer to reality after the Legislature voted on a new state budget plan. The funding, which is a result of the leadership exhibited by Senate President Pro Tem Darrell Steinberg (D-Sacramento), still needs the governor’s signature. Steinberg made the restoration of Adult Denti-Cal a top priority after his visit last August to CDA Cares in Sacramento.
Six leading dental professionals from the Kenya Dental Association recently visited Northern California, including CDA headquarters, as part of a 10-day training program to help develop and promote oral health education activities for a program called Kenya Smiles, aiming to improve the oral health of children in the African country, particularly remote areas. Besides spending time at CDA, the delegation, which included Kenya’s chief dentist and dental school professors, the delegation visited dental schools as well as the State Capitol to be recognized for their work and learn more about advocacy efforts on behalf of children’s oral health.
Legislation aimed at making sure dental plans put more of their revenues into actual care for patients passed its first legislative hurdle. AB 18, authored by Assemblyman Dr. Richard Pan (D-Sacramento) and sponsored by CDA, overcame strong objections from dental plans and health plans.
The move to restore adult Denti-Cal benefits is one step closer to reality after the governor and state lawmakers agreed to include funding in a preliminary budget deal. The restoration of benefits, which still needs final budget approval, would begin in May 2014, with a proposed annual cost of $77 million.
CDA is sponsoring legislation to apply key patient protections and market reforms, including a minimum loss ratio on patient premiums, to dental plans participating in California’s new health plan marketplace, the Covered California health benefit exchange. The Affordable Care Act (ACA) includes many consumer-focused provisions that have already gone into effect, but that only apply to medical plans. Assemblymember Dr. Richard Pan (D-Sacramento), who chairs the Assembly Health Committee, has introduced AB 18, sponsored by CDA, that if passed by the legislature and signed by the Governor, would represent the first time these federal patient protections would be applied to dental plans participating in the small group market inside and outside the new health benefit exchange created by ACA.
Two bills sponsored by CDA this year, one dealing with incentives for retired dentists to provide free care and the other regulation of portable and mobile dental operations, passed the halfway mark in the legislative process last month by receiving unanimous votes in their first houses. After being approved by the appropriate policy and fiscal committees, AB 836 was passed by the full Assembly on April 25 by a 76-0 vote, while the Senate passed SB 562 on May 6 by a 32-0 vote.
Preliminary numbers indicate 2,202 patients received free oral health care at the CDA Cares San Jose dental clinic over the weekend. Hosted by the CDA Foundation and CDA, the May 18-19 dental clinic provided more than $1.6 million in oral health care services to the underserved. The San Jose clinic, which was held at the San Jose Convention Center, was the third CDA Cares event. The three clinics combined have now provided $4.4 million in care to 5,878 patients.
In a positive sign for the millions of Californians in need of access to care, the Senate Budget Subcommittee on Health and Human Services on May 2 discussed the issue of restoring Medi-Cal adult dental benefits. Although no final recommendation was made by the subcommittee, the hearing raised the profile of this issue that has been led by Senate President Pro Tem Darrell Steinberg (D-Sacramento), who has been a vocal champion for bringing back adult dental services since his visit to the CDA Cares free dental clinic held in Sacramento last year.
It has been three years since the passage of the Patient Protection and Affordable Care Act (ACA), and full implementation of the federal health care reform law is now less than eight months away. From nearly the moment of its passage at the federal level, California has been leading other states in working toward its Jan. 1, 2014, implementation, despite the fact that federal regulations providing guidance to states on key implementation details have not all been finalized.
Jim Wood, DDS, has announced plans to run for State Assembly District 2 in 2014. Wood has been a strong voice in CDA for more than 15 years, using the legislative process to promote issues and bills important to dentistry. He has served on the CDA Government Affairs Council and Board of Trustees. He served as chair of CalDPAC from 2005-06 and 2008-12, ensuring that CDA could forge strong relationships with key members of the Legislature.
A recent decision by the Olivehurst Public Utility District to discontinue fluoridation of its community water supply is a reminder that debates concerning fluoride, as well as amalgam, continue to surface in California, and that dentists need to be aware of any activity in their communities. Local dental societies and their members can make an impact with something as simple as offering opinions or suggesting their local elected officials get more information on the subject from the dental society or CDA.
The U.S. Department of Health and Human Services (HHS) recently issued final rules regarding the implementation of the Affordable Care Act (ACA) that included much needed clarification on federal policy related to access to dental care inside and outside of the Health Benefit Exchanges — the health and dental insurance marketplaces created by the ACA.
Gov. Jerry Brown this month appointed two new members to the Dental Board of California.
The CDA Dental Benefits Research Task Force heard from a dental economics expert with the ADA and learned about Oregon’s Coordinated Care Organizations at its January meeting.
California is continuing to move forward with the transition of 875,000 children currently enrolled in the Healthy Families Program (HFP) to the Medi-Cal program, which is expected to begin on Jan. 1. For many months, advocates were pushing for the delay of the transition, but recently, many of those advocates have sensed the inevitability of the transition. The focus of many organizations has turned to ensuring the transition goes smoothly for families and on monitoring access to care as the transition occurs.
Like many people, you may be relieved that the endless election season is over, and that TV commercial breaks are no longer filled with campaign rhetoric. Nevertheless, elections have consequences, and so I would like to provide a sense of how the results of the 2012 national and state campaigns will impact the legislative environment for CDA in 2013.
CDA scored a significant victory in the dental benefits arena recently when Gov. Jerry Brown signed legislation that will place new disclosure requirements on dental plans and insurers when they make material changes to their contracts, rules and procedures. The legislation takes effect Jan. 1, 2013.
The CDA Dental Benefits Task Force, which was approved at the 2011 CDA House of Delegates to develop a deeper understanding of the underlying pressures and trends in dental care financing, conducted several information gathering meetings this year. A summary of the task force’s work was presented to the 2012 House of Delegates on Nov. 10.
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