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FOCUS | ISSUE 3 | 2010


End of Session brings success, disappointment To say it was a strange session is truly an understatement


Budget challenges and election year politics impacted nearly every bill during the fi ve month session. Add to this mix a string of eth- ics violations that needed to be addressed and a federal health care debate and you have the ingredients for a serious log jam.


As session closed, legislators had sent only 91 bills (not including the budget) to the Governor for his signature. By comparison, they approved 144 non-budget bills last year and 117 the year before that (a presidential election year).


With so few bills passing, many good ideas got left on the table. While we did have success this year, unfortunately some of our priorities were included in those left behind.


PROMPT PAY REFORM


One item that did pass this year was a new Prompt Pay Law for insurance companies (see box for details).


Last Fall Governor Nixon noted an increase in the number of provider complaints about slow payments by insurance companies. He instruct- ed his Department of Insurance to examine the current situation and recommend changes to state statute to address the on-going problem.


After the recommendations were provided at the end of last year, MDA and other provider groups began working with insurance compa- nies to develop an improved system.


A compromise was reached that benefi ted pro- viders, which passed both chambers early in the session. Governor Nixon signed the legislation, and the new laws take effect January 1, 2011.


BUDGET


As revenue continued to decline this year, meeting the constitutional requirement to pass a balanced budget dominated much of the leg- islative year. The governor and the legislature spent many hours debating various proposals that could cut state spending – the senate even closed the fl oor one day to examine cost-cutting proposals in a series of bi-partisan small groups.


Ultimately, legislators cut approximately $500 million from the Governor’s proposed budget, and passed a nearly $23 billion 2011 state budget two weeks before the constitutional deadline. However, the Governor still may need to make additional cuts and withholds over the course of the next year in order to keep the budget balanced.


Luckily the budget cuts managed to miss den- tal Medicaid.


With so many cuts necessary, everything was up for consideration this year, and even well supported programs like Parents as Teachers saw cuts. MDA worked hard to remind legisla- tors of the importance of their investment in oral health and managed to avoid cuts this year.


While we are excited about this success, we did not get everything we had hoped from this year’s budget. A proposal to establish a dental carve out was included in the budget when it passed the House, but was stripped by the Sen- ate and left out by the Conference Committee. Additionally, our request for additional funding for the UMKC Dental Clinic was not included in this year’s budget. In fact, higher education as a whole was cut.


Governor Nixon had negotiated an agreement with the state’s colleges and universities before session. His agreement guaranteed a tuition freeze in exchange for no budget cuts. After the cuts made by legislators, it is likely students will see a tuition increase.


HB 2226 – EFDA REGISTRATION


Last fall the Missouri Dental Board passed a rule that would have allowed EFDAs with the proper training to place and carve all classes of amalgam. The board felt, however, that in order to allow this expanded scope of practice, EFDAs should be required to register with the Dental Board similar to dentists and hygienists.


continued page 15


Governor Nixon signed HB 1498 on April 27 at ceremonies in Jefferson City and Cape Girardeau.


Prompt Pay at a Glance


After a study by the Department of Insurance identifi ed delays in the current payment system, the MDA joined with several other provider groups to improve the state’s Prompt Pay Law. The new law includes provisions that will substantially improve the timeliness of reimbursement.


• Bill becomes effective January 1, 2011


• Health Carriers are required to send an electronic acknowledgement of the date of receipt of a claim within 48 hours of being electronically fi led


• The Carrier has 30 days to pay completed claims, or notify the provider that additional information is needed


• The Carrier has up to 15 days to respond once additional information is received


• Any claim not paid within 45 days is subject to a penalty of 1 percent of the total claim amount per day


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