CDA has a dedicated team of professionals whose purpose is to advocate for the profession, including sponsoring legislation at the Capitol that addresses important issues related to dental benefits.
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.
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.
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.
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.
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.
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.
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.
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 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.
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.
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.
If attendance is any indication at a CDA Presents lecture on national health care reform, dentists are eager to learn more about the issue and its impact on their practices as well as employee and personal health coverage. CDA Legislative Affairs Manager Nicette Short presented “National Health Care Reform: How Will It Affect Your Practice?” — a course designed to provide information about the Affordable Care Act and its potential impact on dentists, the oral health care delivery system and the dental benefits market — last month at CDA Presents in Anaheim.
Assemblymember Raul Bocanegra (D-Los Angeles) announced in late April that his legislation intended to permanently place into law various aspects of the state-sponsored Virtual Dental Home (VDH) pilot project will be held until next year to allow time for further clarification of its details.
All TDIC Insurance Solutions plans, including Anthem, Kaiser and others, will be impacted by the Affordable Care Act at levels that are yet to be determined. As we move into 2014, plans continue to cite ongoing increases in the cost of providing health care as reasons for recent actions to raise premiums – even before full implementation of ACA. Because of this, TDIC Insurance Solutions is diligently working with experts in the industry to both determine the possible effects and explore alternatives for its health care policyholders.
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.
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.
CDA is pushing for patients to have a flexible range of coverage options and the ability to choose their dentist, a model that reflects the way dental care historically has been provided.
While many key provisions of the federal Affordable Care Act (ACA) do not take effect until 2014, one element is scheduled to take effect Jan. 1, barring any last-minute change – a 2.3 percent excise tax on “medical devices” that include many dental products such as equipment and prostheses.
Earlier this year, Gov. Jerry Brown proposed and the Legislature approved the transition of all 875,000 of the children currently enrolled in the Healthy Families Program to the Medi-Cal program, which includes coverage for medical, vision, as well as their dental care. CDA has prepared this information for members about the transition.
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.
Legislation defining California’s Essential Health Benefits, which federal health care reform requires to include pediatric oral health benefits, has been signed by Gov. Jerry Brown. SB 951 by Sen. Ed Hernandez (D-Los Angeles) and AB 1453 by Assemblyman Bill Monning (D-Santa Cruz), chairs of the Senate and Assembly Health Committees respectively, define the health, vision and pediatric dental benefits that will be offered through California’s Health Benefit Exchange as part of its implementation of the Affordable Care Act (ACA).
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.
Top Stories: Dental plan disclosure bill signed into law; Dentists should be prepared when learning of an employee disability, Delta Dental meets with task force, discusses industry trends
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.
Top Stories: Health care reform in California: Activity on several fronts; CDA Cares spotlights need for state oral health infrastructure; Compass helps dentists become practice leaders
Top Stories: CDA Cares clinic delivers $1.2 million in care; Symposium at CDA Presents stresses preventing childhood caries; CDA-sponsored bills moving in Legislature
Top Stories: CDA bills tackle dental plan concerns; CDA Cares treatment plan: Relieve pain and infection; TDIC announces rate reduction for CA policyholders
Top Stories: Nonprofits collaborate on workforce; Students learn how Legislature affects dentistry; Affordable Care Act - one year later
Top Stories: Ban on fee caps among laws now in effect; Dental society, health center join forces to open clinic; CDA honored for ‘vision’ in promoting oral health
Top Stories: CDA presentation sheds light on effect of health care reform; Top-notch courses, trade show attract 26,000 to CDA Presents; CDA urges member participation in access solutions
Top Stories: Health care reform: What does it mean for dentists?; CDA Presents refines Anaheim experience; Sample associate agreement highlights overlooked details
Top Stories: Grants put dentists in communities; Insurance, state budget top legislative priorities; A productive new year begins with CDA Compass