eopardy fans, here is the stumper of the day. When was the last time the legislature voted to override a governor budget line item veto? (Sing the jingle if you want.) Oh … I am sorry, your answer was incorrect. The correct answer is “When was Vicki Wilbers in junior high?” Yes, it has been that long ago.


Veto Session Update J


by JORGEN SCHLEMEIER


It’s Missouri Dental License Renewal Time


The Missouri Dental Board reminds licensees that renewal time is NOW! All active dental, dental specialist and dental hygiene licenses will expire Nov. 30, 2014, after which time there is a $100 late fee.


Renewal notices were mailed out the first week of September. If a licensee wants to renew online, they need to have their renewal notice with the corresponding PIN. If a licensee didn’t receive their notice or has misplaced it, they will need to contact the Board office. The Board noted that it has more than 100 reminders that were returned to their office because the licensee had moved and didn’t notify the Board of a change of address.


This year the license renewal fee to $180 for dentists and dental special- ists and $60 for dental hygienists. Dentists and dental specialists are required to obtain 50 CE hours (between the dates of Dec. 1, 2012 and Nov. 30, 2014) of Board-approved CE in order to renew their licenses. A dentist can carry over up to 25 extra CE hours from the previous CE period if they can demonstrate that those hours were in addition to the 50 hours required for the previous renewal.


Questions regarding the upcoming renewal can be directed to the Missouri Dental Board office at 573-751-0040 or dental@pr.mo.gov.


This veto session, the legislature went on an override overdose due to the Governor’s record- setting line item vetoes in the state’s budget. Fifty seven overrides is what the House and Senate accomplished last Wednesday. So what does that mean for dentists or your patients? Not much.


There were three budget items in which we had an interest (actually four, but two of them are combined into one—expansion of adult dental and rate increase).


First, the adult dental expansion, and second, the accompanying rate increase. This item cost the state approximately $17 million, which when coupled with federal match, translates into a $45 million boost to Medicaid dental services in the state. This was not vetoed, but the gov- ernor withheld the funding until he saw the outcome of Veto Session. The legislature, during regular session (January to May) passed several sales tax exemption bills. The governor vetoed 10 of them, noting the cost to the state. The governor withheld funding for many programs in the event the legislature would override not only his budget items, but also the statutory bills, which contained the sales tax exemptions. They did not; therefore, revenue forecast for the state will not be cut—at least for that reason.


Vicki and I are meeting with the State’s Budget Director as well as the MO HealthNet (Medic- aid) director to discuss the release of the funds to implement adult dental, increased rates and the MDA’s carve out program.


The State decided not to implement the dental carve out program for Medicaid enrollees in managed care areas. The new RFPs for the managed care area (I-70 corridor) for health plans will likely be released in the next few weeks, and dental services for that area of the state will remain under managed care contracts. The remainder of the state is currently under Fee for Service, and that may be converted to a more managed program that we have envisioned with a carve out model. We will know more after our meetings.


Third, the Elks Mobile unit ($200,000) and fourth, the Rural Health Clinic Dental program ($500,000) were reinstated by the legislature, but immediately withheld by the governor. So what does an override mean if you don’t get the money?


The governor can either veto a line item, which means that it is just erased from the budget (unless the legislature reinstates during veto session) or the governor can withhold money. If the governor does not veto a line item, he can still not fund it via the use of a “withhold”. Because Missouri, by constitution (yes we actually do follow it) is a balanced-budget state, the government cannot borrow money like other states. Therefore the governor can withhold expenditures to ensure the check book is balanced on the last day of the fiscal year. So, the legislature reinstated by a veto override 57 budget items, and the governor then immediately invoked the “withhold” rule on all 57 items.


Whether anyone has the juice to shake one or more of those 57 loose has yet to be seen.


Final thought: If you want to promote dentistry in the state, then promote dentistry with your state legislator.


ISSUE 5 | SEP/OCT 2014 | focus 17


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