May 10, 2009
The Colorado state legislature completed its regular session on May 6. As always, the CDA worked hard on your behalf at the statehouse. It was a busy session with a number of bills that impacted the dental profession. Primary bills of interest and their final status include:
Bills that Passed
- SB 129 – Bill Concerning the Duties of a Dental Hygienist
SB 129, as originally introduced, expanded the permitted duties of a licensed dental hygienist. The CDA successfully amended this bill to address a number of concerns. A full synopsis of SB 129 and is coming soon. SB 129 was approved by both the Senate and the House and signed into law by the governor on April 21. Although the bill technically went into effect at that time, rulemaking is still in progress. The Colorado State Board of Dental Examiners (SBDE) will consider rules to implement SB 129 at its July meeting.
- HB 1128 – Bill Establishing an Academic License for Dental Faculty
HB 1128 creates an academic license, under the State Board of Dental Examiners, for dentists who are employed by a Colorado school of dentistry and not otherwise licensed to practice dentistry in the state. A dentist with an academic license would not be allowed to practice dentistry outside of his or her academic responsibilities. The CDA supported HB 1128, which was passed by both the House and Senate and signed into law by the governor on March 18.
- HB 1293 – Bill Creating a Hospital Provider Fee to Increase Medicaid Reimbursement and Expand Program Eligibility
HB 1293 creates a hospital provider fee to increase Medicaid reimbursement to hospitals and expand eligibility for Medicaid and the Children’s Basic Health Plan (CHP+). The original bill did not directly impact dentistry, but a $1 million appropriation was added to account for an expected increase in dental benefit claims due to expanded Medicaid eligibility under this program. While appropriations are always welcome, the bill seeks to expand enrollment without addressing problems with dental provider shortages. The bill would improve payments to hospitals but not individual practitioners. The bill was approved by the House and Senate, and was signed into law by the governor on April 21. Several dentists with community health clinic, hospital and Medicaid experience have applied to be on the governing board that will oversee implementation of the bill. We hope that a Board position would bring visibility to dental provider shortages as well as lend insight into whether a fee addressing better payments for individual providers might be feasible.
- HB 1061 – Bill Requiring Disclosure of Insurance Intermediary Entities
HB 1061 requires health insurers to disclose relationships with any contractors or intermediary entities that set policies and standards of care for the plan and to disclose payments made to these entities. The bill would also require any intermediaries used by a health insurer to comply with the standards required of the insurer. The bill was passed by the House and Senate and signed into law by the governor on April 30.
Bills that Died
- HB 1344 – Bill Adjusting Regulation of Medical Malpractice Insurers and Increasing the Limit on Claims for Non-economic Damages
The Colorado Trial Lawyers Association introduced HB 1344, a late session bill that sought to raise limits on medical malpractice claims. HB 1344 would have increased the cap on non-economic malpractice damages to account for inflation, and added an automatic cost-of-living adjustment each year. Automatic cost-of-living adjustments would have added significant uncertainty about future costs and likely caused increases to insurance premiums. The CDA opposed the bill due to concerns about provider costs and access to care. At the House hearing on the bill, the malpractice cap increases were stricken. The bill was defeated on a subsequent vote in the House. Malpractice caps will almost certainly be revisited in a future legislative session. The CDA has offered its expertise to policymakers as a reasonable voice in future discussions.
- SB 9 – Bill Providing Dental Services for Eligible Adults Under Medicaid
SB 9 would have added adult dental services for eligible adults as well as prenatal and postpartum dental care for pregnant women under Medicaid. While the bill has broad support, including support from the CDA, and has been a chief priority for many Colorado policymakers, it did not pass this year due to lack of available funding.
- HB 1116 – Bill Allowing Colorado General Funds to be Used for Children’s Dental Programs
Colorado law currently prohibits the use of state general funds to implement children’s dental assistance programs HB 1116 would have repealed that prohibition. At this time, the Children’s Dental Assistance Program is funded through federal grants. The bill did not change any appropriations; it simply would have allowed the use of general funds in the future, should they be required. The CDA supported HB 1116. The bill was passed by the House and approved by the Senate HHS Committee but died in the Senate Appropriations Committee.
- HB 1084 – Bill Limiting Timeframe and Paperwork for Medicaid Audits
HB 1084 would have limited the timeframe on audits of healthcare providers to the calendar year of the audit and the two prior calendar years. Requests for records would be limited to 15 days during each of the three years covered by the audit, except in cases of deliberate or reckless false claims by the provider. The CDA supported HB 1084. However, due to state concerns about lost revenue and compliance with federal audit standards, the bill died in the House Health and Human Services (HHS) Committee.
- SB 12 – Bill Regarding the Professional Review of Healthcare Providers
As introduced, SB 12 permitted specified groups to review the professional conduct and patient care practices of healthcare providers. It also granted immunity protections to groups authorized to perform such reviews. In the Senate, the scope of the bill was restricted to emergency care providers in trauma centers. The bill no longer addressed dentists, as peer review for dentists was already addressed under the Dental Practice Act. The modified bill was defeated by the House HHS Committee. It is likely that the legislature’s healthcare task force will review this topic again during the summer recess.
- SB 61 – Bill Requiring a Dentist/Physician to Review Insurance Coverage Denials
SB 61 would require health insurance companies to have a Colorado licensed doctor or dentist, as relevant, on staff to review any denials of benefits. The CDA monitored the progress of SB 61, which passed in the Senate but lost in the House.
- HB 1273 – Bill Establishing a State Authority to Implement a Single Payer System
HB 1273 would have created a governing entity to implement a single payer healthcare system for Colorado. Oral health services were included in the plan and the implementing board included a dentist as one of the 23 directors. The bill died in the House.
- SB 46 – Bill Concerning Health Snack Foods in Schools
SB 46 detailed extensive criteria for healthy snack foods that would be allowed on school campuses. It prohibited the sale of snacks that do not meet the criteria. The CDA signed a letter of support for SB 46, along with a coalition of healthcare providers. However, the bill died in the Senate Education Committee.
This year, the State of Colorado faced a significant budget shortfall, requiring new revenue sources and reductions to account for a budget imbalance of $1.5 billion. The budget situation dictated the outcome of many bills, especially those requiring state funds for implementation.
In this environment, appropriations for public programs, including Medicaid reimbursement rates, were subject to cuts. The CDA worked to ensure that cuts to dental reimbursement were as minimal as possible. The final rate cut for dental providers was 2 percent (down from a previous proposal of 5.8 percent). The Medicaid office is attempting to avoid an across the board rate cut and has reached out to practitioners for ideas on other ways that costs can be reduced. Please contact Jennifer Goodrum at 303-996-2847, 800-343-3010 ext. 107 or jennifer@cdaonline.org if you have ideas to share.
For ongoing information about bills that the CDA is tracking, as well as emerging legislative plans for 2010, please visit our new legislative website at http://capwiz.com/dental/co/.
