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09/17/2013

CDA legislation moves forward as 2013 session closes


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.

Already passed and signed into law is AB 836 (Skinner), which will ease a barrier to retired dentists providing volunteer care by reducing from 50 hours to 30 hours the biennial continuing education (CE) requirement for dentists who maintain a retired licensure status. The bill specifies that the 30 hours of CE would all have to be in areas directly related to the delivery of dental services. 

The Dental Practice Act has a special “retired” status for dentists who wish to maintain their licenses. A dentist who has practiced for 20 years or more and has reached retirement age may choose retired status, which allows him or her to continue providing uncompensated dental care, reduces the biennial license renewal fee by 50 percent, but requires him/her to continue to complete the full 50 units of CE. AB 836 will provide a further incentive to maintain retired status and provide volunteer care by reducing the CE requirement to 30 units. The new law will become effective Jan. 1, 2014, but may require some additional time for implementing regulations to be adopted. 

A second CDA-sponsored bill, SB 562 (Galgiani), received unanimous final votes in both houses and is on its way to the governor, who has until Oct. 13 to sign or veto the bill. SB 562 would require portable dental practices, which bring equipment into nondental office settings, to register with the Dental Board of California in the same manner as is currently required of mobile vans. The bill also requires the dental board to adopt expanded regulatory standards for mobile and portable operations to assure continuity of care, patient record availability, and adequate disclosure to and consent from patients or parents for treatment performed. 

SB 562 is a follow-up to a multi-year effort to work with school and county health officials on guidelines for schools to use in evaluating proposals by portable dental companies or clinics to provide oral health services to children. That process identified the regulatory gap in current law which leaves the dental board with no oversight of portable dental practices as opposed to standalone mobile dental vans. The bill is intended to assure that mobile and portable practices must adhere to the same basic standards of care that apply to all other dental professionals.

CDA’s final sponsored bill, AB 18 (Pan), is being held until next year so that it can be broadened to cover all dental benefit plans doing business in California. AB 18 was introduced earlier this year as a vehicle for making necessary changes to the laws governing dental plans participating in the new Health Benefit Exchange created as part of the state’s implementation of the federal Affordable Care Act. The focus at the beginning of the legislative year was on clarifying the ability of standalone dental plans to participate in the Exchange and on establishing an appropriate “medical loss ratio,” limiting the proportion of enrollee premiums that can go to administrative expenses instead of patient care (specialized plans such as dental have been exempted for many years from MLR requirements that apply to health plans). 

Over the course of the year, discussions with Exchange staff, its board members and the Department of Managed Health Care have led to administrative answers or solutions to many of the issues that CDA had identified at the time that AB 18 was introduced, but the issue of a medical loss ratio (MLR) for dental plans remained a source of contention with the health and dental plan industry. As the 2013 session neared a close, CDA’s Government Affairs Council elected to ask Assemblymember Richard Pan, MD, to hold the bill for the remainder of 2013 in order to continue working on the MLR issue and to look at expanding the bill in 2014 to apply to all dental plans sold in all markets, not just those that participate in the Exchange.