Gov. Brown signs CDA-sponsored loan repayment bill

In the final weeks of the state's 2016 legislative session, Gov. Brown signed into law several bills that impact dentists, including CDA-sponsored Assembly Bill 2485 (Santiago, D-Los Angeles).

Taking effect immediately as an urgency statute, AB 2485, the Dental Corps Loan Repayment Program, revises in the applicant's favor provisions regarding program eligibility, application, selection and placement.

The program was established in 2002 and funded with $3 million in grants for dental school graduates who commit to providing care in underserved areas for three years. The Dental Board of California selects recipients and distributes the grants; however, more than $1.5 million in funding remains, as restrictive provisions have made it difficult for individuals to qualify for the program. CDA collaborated with the dental board to remove and address barriers to the funds, allowing them to be more effectively disbursed and to increase the number of dentists working in underserved communities.

Summarized here are other dental-related bills the governor signed into law:

AB 72 (Bonta, et al.) – Health care coverage: out-of-network coverage
This bipartisan balance billing legislation, with co-authors including Assemblymember Dr. Jim Wood, maintains fair billing practices for dentists as a result of CDA's advocacy work. As previously reported in the September CDA Update, AB 72 significantly improves upon last year's balance billing legislation, which CDA actively opposed because it "greatly missed the mark on provider protections." That bill, AB 533, failed to pass an Assembly vote.

AB 72 is a compromise bill that provides stronger patient protections from surprise bills while balancing the needs of health care providers and health plans. Under the bill, out-of-network physicians providing treatment at an in-network hospital or clinic must receive a patient's voluntary consent to be treated for out-of-network care at least one day before the treatment. Patients who do not consent to treatment cannot be billed for more than the in-network cost sharing, and out-of-network physicians would instead be reimbursed at either a Medicare-based or insurance-based rate, whichever is greater. Because many dental services are not covered by Medicare or general health insurance, and because dentists were not an intended target of the legislation, CDA successfully advocated for their exclusion from the bill.

AB 2207 (Wood, D-Healdsburg) – Medi-Cal: dental program
This bill is intended to improve the Denti-Cal program by requiring the Department of Health Care Services to perform certain activities, such as putting into place an expedited enrollment process for providers and monitoring dental service access and utilization. The bill also adds performance measures, such as requiring the DHCS to post dental fee-for-service program performance data, dental health plan performance measures and each dental health plan's performance on a quarterly basis on its website beginning April 30, 2017.

AB 2235 (Thurmond, D-Richmond) Board of Dentistry: pediatric anesthesia: committee
As covered in the October CDA Update, this bill was introduced in response to a tragic incident involving the use of general anesthesia for a pediatric dental patient. Following in-depth discussions with the author, the patient's family and other stakeholders, many amendments were made to the original bill language, with CDA supporting the bill ultimately signed by Gov. Brown. The new law requires the dental board to review current state policies on the use of anesthesia for minors, additional specificity in the written informed consent for these patients, and additional data collection around anesthesia-related adverse events. CDA is also actively supporting the dental board's review of state policies on anesthesia and sedation to ensure children and adults have access to the highest and safest standards of care. The board's recommendations, in the form of a final report, are due to the Legislature by Jan. 1, 2017.

AB 2331 (Dababneh, D-Encino) – Dentistry: applicants to practice
This bill creates another pathway to licensure for out of state dental school graduates. It allows the dental board to accept the ADEX exam as an option for licensure in California after an analysis has shown it meets California's licensing standards. It also requires that ADEX pay for all reasonable costs and expense incurred by the board in implementing the ADEX dental examination. This exam option will allow out of state dental students, including California residents studying out of state, the opportunity to take the ADEX exam for their license in California.

AB 2744 (Gordon, D-Menlo Park) – Healing arts: referrals
See the article, "Advertising on Groupon allowable under new law," in the upcoming November issue of the CDA Update.

SB 482 (Lara, D-Bell Gardens) – Controlled substances: CURES database
Providers are required under this bill to consult a patient's electronic history in the CURES database before prescribing a Schedule II-IV controlled substance to a patient for the first time. The bill also requires the prescriber to consult the CURES database at least once every four months when the prescribed controlled substance remains part of the patient's treatment. CDA negotiated exemptions under certain specified circumstances, such as when a dentist is prescribing the controlled substance as part of a treatment plan for a patient following a surgical procedure, and the prescription is for a five-day or less supply, and nonrefillable. This bill builds on recent legislation that requires all prescribers to register to access the CURES database as of July 1, 2016. CDA has reported extensively on CURES. For more information about this bill, see "CURES: mandatory check proposed" in the August CDA Update.

SB 1098 (Cannella, R-Ceres) – Medi-Cal: dental services: utilization rate: report
This bill came out of recommendations made by the Little Hoover Commission. It requires the Department of Health Care Services to report to the Legislature, by Oct. 1, 2017, on progress toward the goal of raising the Denti-Cal utilization rate among eligible child beneficiaries to 60 percent or greater and identify a projected date by which the goal will be met. The report in the bill will continue to build pressure for improvements to the program through legislation and the state budget.

For more details about the legislation covered here, visit the News section at cda.org. CDA Practice Support will continue to develop and provide related resources for members at cda.org/practicesupport.

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AB 72 furthers consumer protections while also making it easier for physicians to resolve reimbursement problems with insurers. Under this bill, out-of-network physicians providing treatment at an in-network hospital or clinic must receive a patient’s voluntary consent to be treated for out-of-network care at least one day before the treatment.