Colorado’s General Assembly adjourned its annual 120-day session on Monday May 8, having considered a total of 617 bills with 472 bills ultimately becoming law. This was one of the more contentious sessions in recent memory with bitter divides between and within political parties. The Democrats had a near supermajority in both the Senate and the House but had to work hard to keep their own party aligned – particularly in the House, which had nearly 50% of the body serving as new members and all new leadership.
Gun control, affordable housing, workers’ rights, and air and water quality were key themes this legislative session, along with affordability, mental health access and reproductive care in the health space. This legislative environment was favorable to some of the CDA priorities, particularly those in the public health arena.
This session, the CDA monitored over 50 bills. Some of dentistry’s key accomplishments this legislative session included:
- Dental Insurance Transparency Reform: SB23-179 (PASSED) defines a Dental Loss Ratio (DLR) and requires that dental insurers disclose how much of premium dollars collected from patients actually go to dental care. Dental plan premiums have increased steadily through the years without much, if any, increase in coverage. This bill will help track where premium dollars are going, and how to maximize patient benefits going forward.
- Payments via Virtual Credit Card: HB23-1116 (PASSED) is another insurance reform bill. It requires payments from insurance companies to providers to be supplied in a manner that DOES NOT incur fees to redeem payment (such as a virtual credit card). If this practice were permitted to continue, it would essentially allow dental plans effectuate a de facto rate cut, pocketing a portion of the reimbursement due to dentists without changing upfront fee schedules.
- Medicaid and Public Health Wins: In addition to PASSING a 3% rate increase for all Medicaid providers (effective July 1, 2023), dentistry was successful in ELIMINATING the annual maximum $1,500 limit for the adult Medicaid dental benefit as well as any copays for dental services or prescription drugs for all Medicaid clients. This will allow full patient treatment plans to be delivered without delays, and also takes effect July 1, 2023. HB23-1300 (PASSED) commissions a study of extending patients’ Medicaid eligibility timelines. Extended patient program eligibility could help greatly with treatment continuity for patients with multi-phase dental procedures – things like orthodontics, prosthetics, oral surgery and more. Federally Qualified Health Centers (FQHCs) received $14M of funding increases for dental (and other critical health) services. Additional review of Medicaid dental reimbursement rates is slated for consideration in both 2024 (limited) and 2025 (full). HB23-1295 (PASSED) will review audit protocols for the Medicaid program and make recommendations on practices to increase fairness for providers.
- Care for Senior Adults: SB23-031 (PASSED) will fund new geriatric education cross-training tracks for healthcare professionals including dentists. This training track will focus on best practices in treating medically complex, vulnerable older Coloradans with an aim toward improving access and quality of care. Given a growing population of seniors and gaps in their dental care, additional collaboration and training can hopefully drive more long-term solutions to senior dental care needs.
- Workforce Expansions: HB23-1246 (PASSED) funds $40M in grant programs at community, technical and some four-year colleges to assist students who want to go into high-demand careers – which may include programs like dental assisting or even dental hygiene.
The CDA was fortunate to partner with many great dental affiliates and organizations to achieve these wins – including groups like the Colorado Society of Oral and Maxillofacial Surgeons (CSOMS), Comfort Dental, the Association of Dental Support Organizations (ADSO), the Colorado Community Health Network (CCHN) and many more.
Beyond dental specific bills, there were a number of bills with impacts on general business operations. Workers’ rights were extended in several bills this session. SB23-058 (PASSED) bans employers from asking for age-identifying information on job application materials. SB23-105 (PASSED) increases enforcement for equal pay laws. SB23-017 (PASSED) gives employees the option to use paid sick leave to attend to a family member whose school or place of care was closed for inclement weather or to deal with the fallout of a death in their family. SB23-111 (PASSED) increases the rights of certain public employees by essentially aligning Colorado’s public workplaces with the National Labor Relations Act, which does not currently cover public employers.
In addition, in the broader healthcare space, several bills passed expanding scope for mid-level health providers. HB23-1071 (PASSED) gives psychologists the ability to prescribe certain psychotropic medications. SB23-083 (PASSED) expands independent practice by physician assistants. SB23-288 (PASSED) expands Medicaid recognition and payments for doula services. These trends are important to monitor in terms of precedents for dentistry, particularly as dentistry prepares for future scope of practice reviews and conversations.
The full legislature will now stand in recess until next year’s session, which begins Jan. 10, 2024, barring any special sessions being called by the governor. However, several interim and year-round committees will still meet throughout the fall. Budget and policy discussions will also continue over the interim with a Nov. 1 deadline in place for the governor to submit fiscal year 2023-2024 department budget requests to the legislature’s Joint Budget Committee.
Several significant dental bills are expected in the 2024 legislative session including efforts to expand school dental screenings, increase license portability through an interstate compact, review the state’s Low Income Senior Dental Care program, increase Medicaid reimbursements, and further reform both Medicaid audits and dental insurance.
In 2024, the CDA will continue to invest substantially in policy preparation for the Dental Practice Act Sunset Review, a process where all the state laws governing the practice of dentistry are reviewed for efficiency and effectiveness every 7 to 10 years. Already, a workgroup of 16 dentists has spent the past year conducting a line-by-line review of the Dental Practice Act to make notes and recommendations on updates and changes. The workgroup prepared 23 resolutions for consideration at the June 2023 CDA House of Delegates. Based on the 22 recommendations approved at the CDA House, the Sunset Review workgroup will formulate a recommendations report to share with state reviewers at DORA, who will begin their comprehensive review and stakeholder process in late fall of 2023. The DORA reviewers will issue a public report with recommendations on changes to the Dental Practice Act at the conclusion of this input process in fall of 2024, and a bill based on this report will run in the state legislature in 2025 to make final changes and updates to the Dental Practice Act. The CDA will be actively involved to advocate for dentistry’s priorities throughout this process in the two years ahead.
In June, the CDA was directed by the 2023 CDA House of Delegates to pursue a Sunrise Review report from DORA on potential scope of practice expansions for dental assistants with an eye toward addressing current workforce constraints. The information from this Sunrise Review report will be further considered by the 2024 CDA House of Delegates in determining any policy next steps.
Your involvement in the policy process continues to be critical. Please save the date and plan to join the CDA in advocating for key policy priorities at the next Dentists at the Capitol State Lobby Day on Friday, February 23, 2024, from 7 a.m. to 1 p.m.
Scan this QR code to register!
The CDA is also looking for dentists willing to serve as legislator liaisons, through a program called the “Action Team Leader” network. No prior experience is needed, and you will be paired with a mentor dentist who will help coach you on outreach and involvement. For more information or to volunteer, scan this QR code.
