{ legislative & regulatory } by Olivia Wilson • MDA Legislative Liaison


Looking Ahead to 2023 T


he recent session marked one of the most successful years in the Association’s history, legislatively speaking. In 2022, we passed


three of our four legislative priorities, includ- ing legislation to allow for in-office dental plans, and updates to Missouri’s prompt credentialing and assignment of benefits statutes to include pre-paid dental plans such as Delta Dental. Additionally, we secured a historic rate increase for Missouri’s dental Medicaid providers, meaning dentists taking Medicaid patients will now be reimbursed at a level comparable to most commercial in- surance. At the national level, the passage of Question 2 in Massachusetts (read more on the page 20) has led to discussions across the country about medical loss ratio, and what that looks like for dental insurance compa- nies. It will be tough to match the successes of 2022, but your MDA lobbying team is up for the challenge. The following legislative agenda was discussed and approved by the MDA Legislative and Regulatory Committee and Board of Trustees at the recent MDA Board and House of Delegates meetings.


Legislative Priorities


NETWORK LEASING FIX Current state law mandates dentists must be allowed to “opt-out” of network plans contracted through a third party on behalf of a health insurance carrier. During the 2022 legislative session, we filed legislation in the House with Rep. Bishop Davidson (R-Republic) that would enhance the current statute to include an “opt-in” provision, therefore requiring initial contracts between a health carrier and provider contain lan- guage explicitly stating the carrier holds the authority to lease out their carrier plan. In 2023, we will re-file this legislation with Rep. Davidson in the House and a new sponsor in the Senate.


18 focus | NOV/DEC 2022 | ISSUE 6 VIRTUAL CREDIT CARDS, ADD “OPT-IN”


In 2019, the MDA worked with a coalition of health care providers to pass legislation to require health insurance carriers utiliz- ing alternative methods of reimbursement (such as virtual credit cards), to notify the provider of initiating/changing such method of payment, and permit the provider to select an alternative payment method (opt-out). Despite this law change, we continue to hear stories from providers who still are being paid via virtual credit cards despite opting out. In 2023, the MDA will file legislation to include an “opt-in” provision. This would require insurance carriers to receive explicit consent from the provider before utilizing an alternative method of reimbursement, such as virtual credit cards.


REMOVE DELTA DENTAL EXEMPTION


Delta Dental of Missouri has its own statute in state law that defines them as a “pre-paid dental plan” and exempts them from laws regulating all other insurance carriers. Be- cause of this exemption, the MDA has spent significant legislative capitol over the last decade adding Delta Dental to various insur- ance regulations as new issues arise. Most re- cently, the MDA passed legislation to include Delta Dental of Missouri under Missouri’s assignment of benefits (AOB) laws. Despite passing this bill with no opposition from Delta Dental, the company refuses to comply with the assigning of a benefit requested by a patient to the provider since the enactment of the law in August 2022.


In 2023, we will file legislation to remove Delta Dental’s special exemption altogether. By removing their exemption in statute, Delta Dental would be under the purview of the Missouri Department of Insurance and subject to the same regulations as other insurance companies, hopefully alleviating future legislative burdens of the Association. Additionally, we will continue to pursue con-


versations with the Attorney General’s office regarding enforcement of these regulations, especially when a new Attorney General is appointed by the Governor in January.


Appropriations Priorities


We will advocate for full funding for Donated Dental Services and Elks Mobile Dental Services again in the FY24 state budget. Additionally, we look forward to continuing conversations with members of the House and Senate budget committees to maintain this year’s historic increase to Missouri’s Dental Medicaid program.


Legislative Events


VIRTUAL TOWN HALL, FEBRUARY 1 Like last year, the MDA will host two advo- cacy events in 2023: virtual and in-person. First, make plans to attend the third annual MDA Virtual Legislative Town Hall the eve- ning of Wednesday, February 1. This is a great opportunity for members to hear from lead- ers of the Missouri Legislature directly and ask questions, all from the comfort of your home. Last year’s panelists included Mis- souri Senate Majority Leader Caleb Rowden, Senate President Pro Tem Dave Schatz and Speaker of the House Rob Vescovo.


DENTAL DAY AT THE CAPITOL, MARCH 1


Then join the MDA Wednesday, March 1 at the Missouri State Capitol in Jefferson City for Dental Day! Last year, after a brief hiatus due to the COVID-19 pandemic, members from all corners of the state attended meet- ings with 35 state representatives and sena- tors to advocate for our legislative priorities during Dental Day. Without a doubt, this face-to-face interaction between dentists and legislators surely contributed to our successes in 2022. Stay tuned for details and registration!


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