y the time you’re reading this, Missouri legislators officially will be halfway through the 2021 legisla- tive session. As I write, Senators and Representatives are on a week-long spring break before returning March 22. Just one year ago, legislators of the 2020 General Assembly went home for the annual break but never returned due to the Coronavirus pandemic. Legislators have confirmed upon reconvening, it will be full steam ahead.
Despite the stop-and-go session, lawmakers in both chambers have made progress on sev- eral high-priority issues. The House passed a Wayfair tax bill (HB 554, Rep. J Eggleston, R-Maysville), 115-44. This bill would require companies to charge a sales tax when people shop online. It is referred to as the “Wayfair” tax after the 2018 Supreme Court land- mark case (South Dakota v. Wayfair), which determined states can mandate businesses without a physical presence in the state to collect a sales tax on transaction made within the state. Missouri is just one of seven states without a Wayfair tax. The Senate passed its own version of the same bill. Now both bills will go to the joint House-Senate Conference Committee to reconcile the differences.
Just before lawmakers left for the spring break, the Senate passed a gas tax increase. Missourians would see a 2.5 cent increase over five years, bringing the total tax to 29.5 cents by 2026. However, Missourians are eligible to file for a rebate if they keep their receipts. If approved by the House and Gov- ernor, it would be Missouri’s first tax increase in 25 years, and would bring in up to $460 million for much-needed road and bridge updates. Missouri has the third lowest gas tax rate in the nation.
DENTAL PRIORITIES
The MDA identified five priority issues to focus on during the 2021 legislative session. The following is an update on how these issues are progressing as of press time:
Downcoding: We have filed identical bills in both chambers intended
to permanently stop insurance providers from downcoding submitted claims. Down- coding refers to the growing phenomenon experienced by a variety of healthcare provid- ers in which an insurance provider modifies the procedure code originally submitted and reimburses a lower amount attributed to the new code instead of the originally submitted code and amount. SB 401 (Sen. Bob Onder, R-St. Charles) will have its first public hearing upon returning from spring break, where the MDA will provide testimony in support of the bill. The identical House version (HB 1357, Rep. Suzie Pollock-R, Lebanon) has been referred to the House Committee on Insurance but has not yet been scheduled for a hearing.
Credentialing: Last year, the General As- sembly passed HB 1682, which, among other things, included provisions to enforce prompt credentialing for health care provid- ers. A Missouri dental insurance carrier has not adhered to the new law, citing exemp- tion based on tax status. HB 1002 (Rep. Wayne Wallingford-R, Cape Girardeau) and the identical SB 484 (Sen. Elaine Gannon-R, DeSoto) would mandate all insurance carri- ers follow the prompt credentialing statutes set forth in last year’s bill. Rep. Wallingford’s bill was heard in the House Health and Mental Health Committee on March 8, and
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we expect it to be voted out of the committee after spring break.
Vaccine Delivery: At the request of the Mis- souri dental schools, two bills have been filed to allow for dentists to administer vaccines. HB 628 (Rep. Danny Busick, R-Newtown) and SB 322 (Sen. Steven Roberts, D-St. Louis) would both allow for licensed dentists to administer vaccines, including the COVID-19 vaccine. SB 322 was referred to the Senate Health and Pensions committee in early February but has not yet been scheduled for a hearing. HB 628 will be heard in the House General Laws committee on Monday, March 22. The MDA supports this legislation as long as it includes three essential components: 1) dentists must not be mandated to administer vaccines; 2) vaccine must be specific to the oral cavity, or in the case of declared state of emergency, such as COVID-19; and, 3) den- tists must complete a Missouri Dental Board recognized training.
In related vaccine news, on March 11, the U.S. Department of Health and Human Services amended its emergency medical countermea- sures declaration under the Public Readiness and Emergency Preparedness (PREP) Act by extending temporary civil liability protection to dentists and dental students who admin- ister COVID-19 vaccines. In effect, dentists and dental students across the country are
