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10/31/2012

Dental Benefits Task force recaps busy year


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.

As part of its information gathering phase, the task force met seven times this year at the CDA headquarters in Sacramento where it heard presentations from experts and discussed the following topics:

  • Health care reform: drivers nationally, California activities
  • Employer benefit purchasing trends; brokers’ role and perspective
  • Market factors affecting benefit purchasing decisions, plan designs, and provider network development
  • Dental practice types and trends: Dental PPA, group and corporate practice
  • Role of quality assurance and performance measures in benefit designs and reimbursement policies
  • Health plan models that integrate medical and dental through reimbursement structure

The most recent meeting in October featured a presentation by Delta Dental that covered marketplace trends and how that has affected the way the company does business. 

The task force’s objective is to identify strategies to enhance the position of providers and patients in the dental benefits marketplace.

“It is important for us as a profession to be ahead of the curve when it comes to the dental benefits industry, and the research we have compiled so far in 2012 is going to put us in a good position to report some key findings to the House of Delegates next year,” said chair of the task force, Walter Weber, DDS.

The Dental Benefits Task Force will continue the information gathering phase into 2013.

Also in the dental benefits arena, CDA scored a significant victory in September as 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. AB 2252 (Gordon; D-Menlo Park), sponsored by CDA, requires plans to provide written notice to providers within 45 business days of any material changes to a plan’s rules, guidelines, policies and procedures concerning dental provider contracting or coverage of or payment for dental services.  The new law will ensure that plans provide timely notice to their network dentists whenever they change or freeze rates, limit coverage of certain services, or otherwise change the rules in midstream. 

The legislation takes effect Jan. 1.