WVDA introduces legislation to stop discounting fees not covered by insurers
The West Virginia Dental Association had legislation introduced in the 2019 West Virginia Legislature that is intended to prohibit insurers and other third parties from requiring dentists to discount fees for services provided but not covered by the insurers.
Three bills have been introduced by lawmakers to cease such tactics. These are Senate Bill 262, Senate Bill 310 and House Bill 2361. "The language of all the three bills is the same," said Richard Stevens, WVDA Executive Director. "We had overwhelming support from lawmakers to introduce the legislation once they understood the onerous action by some insurers and third parties."
The proposed legislation prohibits insurers from providing nominal reimbursement for a service in order to claim that a dental service or material is covered. It also prohibits a dentist from charging more for covered services than her or his customary or usual fee for the service.
The following information was conveyed to legislators by WVDA in request of their support::
(1) 38 states have passed this legislation;
(2) 97% of Senators and 94% of Delegates voted for this legislation in those 38 states;
(3) The National Conference of Insurance Legislators adopted the "Model Act Banning Fee
Schedules for Non-Covered Dental Services" in 2010;
(4) The National Licensing Boards of Dentistry report no complaints from patients related to
increased costs for non-covered dental services; and
(5) The proposed legislation, sought by WVDA prohibits a dentist from charging a patient
more for a non-covered dental service than they usually charge.
The proposed legislation also reads that a health care service contractor or other person providing third party administrator services shall not make available any providers in its dentist network to a plan that sets fees for any services except covered services.
Senators supporting WVDA and introducing the legislation are: Tom Takubo, Michael Maroney, Ron Stollings, Glenn Jeffries, Robert Beach, Roman Prezioso and Charles Trump. Delegates introducing the legislation are: Steve Westfall, Joe Ellington, Doug Skaff, Joe Canestraro, Andrew Robinson, Andrew Byrd, Tim Miley and William Hartman.
National Children's Dental Health Month
Every February is National Children's Dental Health Month, which is a month-long national health observance for raising awareness abut the importance of oral health. It is for promoting the development of good dental habits at an early age. It is also a reminder of the importance of getting regular dental check-ups that are beneficial in getting an ideal start in a lifetime of having healthy gums and teeth. The yearly campaign is not just for children and their parents, but it also targets teachers and dental health professionals. The American Dental Association and West Virginia Dental Association encourage parents to take their children to their dentists at least every six months, and follow instructions by their dentists to improve and maintain good oral health care. Contact an ADA-WVDA dentist for information.
West Virginia Dental Association will hold its 113th Annual Session, July 18 - 20, 2019, at The Greenbrier Resort in White Sulphur Springs, WV. Call 304-344-5246 or email wvdental.org for information.
News & Events
The West Virginia Dental Association invites dentists, dental hygienists, dental assistants, dental suppliers and dental laboratories to its Semiannual Session in January and Annual Session in July of each year. A host of scientific and clinical programs are presented at each meeting, assuring attendees of worthwhile educational experiences.
For information call 304-344-5246, or email firstname.lastname@example.org or email@example.com For the latest news go to: www.wvdental.org
2019 Semiannual Session
The West Virginia Dental Association will hold its 2019 Semiannual Session January 18 and 19 at
The Marriott Hotel in Charleston, WV. A variety of quality education programs are available to dentists, as well as expanded duties courses for dental hygienists and assistants.
Of major importance to dentists is the risk management seminar, sponsored by the Professional Protector Plan for Dentists. Dentists attending this course can earn 4.5 hours of CE credit and up to 15% discount on their malpractice insurance premium for three years.
Also of importance to dentists and dental hygienists is the drug diversion and best practices prescribing controlled substance training, and training on prescribing and administering opioid antagonist. This three-hour program is required of dentists by West Virginia law.
Courses available to dental assistants and hygienists are: coronal polishing for restorative and orthodontic assistants; nitrous oxide monitoring for dental hygienists and assistants; expanded duties for orthodontic assistants; and restorative expanded duties for dental assistants. Completion of these courses permits the hygienist and assistant to perform these procedures under the supervision of their dentists.
Dr. James Kohner of Colorado will present two, three-hour courses on January 19. They are "beating up on your patient's periodontal disease: a minimally invasive anti-microbial treatment," and "how crown lengthening will enhance your restorative results."
Dr. Brett Eckley will be installed into office as President for the coming year by Dr. Chris Smith, the outgoing President. Other officers to be installed are: Dr. Douglas Robertson, President Elect;
Dr. Eleisha Nickoles, Vice President; Dr, Gerald Veltri, Treasurer; Dr. Lance Pittman, Secretary;
Dr. Michael Medovic, ADA Delegate Chair; and Dr. Michael Richardson, ADA Delegate.
Dr. Medovic will be presented the Dr Robert B. Bridgeman Distinguished Dentist Award in recognition of his involvement with dentistry at the local, state and national levels. In addition to service as President of WVDA, he has served a delegate and alternate delegate to the American Dental Association.
Registration for the meeting can be attained by calling WVDA 304-344-5246.
WVDA To Support Covered Services Legislation
The West Virginia Dental Association (WVDA) will pursue legislation during the 2019 Legislature that will prohibit insurance companies from requiring dentists to provide discounts for dental services which are not covered by the insurance company.
The proposed language is to read: "No contract of any health care service contractor that covers any dental services, and no contract or participating provider agreement with a dentist may require, directly or indirectly, that a dentist who is a participating provider provide services to an enrolled participant at a fee set by, or a fee subject to the approval of, the health care services contractor, unless the dental services are covered services."
The proposed legislation also reads: "A health care service contractor or other person providing their party administrator services shall not make available any providers in its dentist network to a plan that sets dental fees for any services except covered services."
The legislation will also read: "A dentist may not charge more for services and materials that are not covered services under a dental benefits policy than his or her usual and customary fee for those services and materials."
Finally, the proposed legislation will read: "Reimbursement paid by a dental plan for covered services and materials shall be reasonable and may not provide nominal reimbursement in order to claim that services and materials are covered services."
The National Conference of insurance Legislators adopted this legislation in March 2017. It is titled "Model Act Banning Fee Schedules for Uncovered Dental Services." In summary, it "prohibits a dental insurance plan from requiring a dentist who provides services to its subscribers to accept a fee set by the plan for any service except covered services."
"Over 30 states have passed similar legislation," said Richard Stevens, Executive Director. "We will be asking legislators to follow the lead of other states," he said.
2019 Officers to be installed at Semiannual Session
Dr. Jon Christopher Smith of Charleston and President will install newly elected officers at the West Virginia Dental Association's 2019 Semiannual Session, January 19, at the Marriott Hotel in Charleston.
Dr. Brett Eckley of Beckley will be installed President, a position he will hold until January 2020. Following his installation, Dr. Eckley will preside over the Executive Council meeting, January 20.
Dr. Smith will also install Dr. Eleisha J. Nickoles of Wheeling as Vice President. She will also serve as Alternate Delegate to the ADA during her one-year term.
Dr. Lance M. Pittman of Martinsburg will be installed Secretary and Alternate Delegate to the ADA.
He will be eligible to be elected to three more one-year terms as Secretary.
Dr. Gerard A. Veltri of Clarksburg will go in as Treasurer. He, too, is eligible to be elected to three more terms as Treasurer.
Dr. Michael D. Medovic of Wheeling will fulfill his final term term as ADA Delegate, January 2020.
Dr. Michael L. Richardson of Charleston will begin his first, two-year term as Delegate to the ADA at the Semiannual Session. He is eligible for election to the post two more times.