The 2023 Missouri Legislative session begins Wednesday, January 4 and runs through mid-May. The legislative agenda was approved by the MDA Legislative and Regulatory Committee and the MDA Board of Trustees in November 2022.
by Olivia Wilson
The recent session marked one of the most successful years in the Association’s history, legislatively speaking. In 2022, we passed three of our four legislative priorities, including legislation to allow for in-office dental plans, and updates to Missouri’s prompt credentialing and assignment of benefits statutes to include pre-paid dental plans such as Delta Dental. Additionally, we secured a historic rate increase for Missouri’s dental Medicaid providers, meaning dentists taking Medicaid patients will now be reimbursed at a level comparable to most commercial insurance. At the national level, the passage of Question 2 in Massachusetts (read more on the page 20) has led to discussions across the country about medical loss ratio, and what that looks like for dental insurance companies. It will be tough to match the successes of 2022, but your MDA lobbying team is up for the challenge. The following legislative agenda was discussed and approved by the MDA Legislative and Regulatory Committee and Board of Trustees at the recent MDA Board and House of Delegates meetings.
Legislative Priorities
Network Leasing Fix
Current state law mandates dentists must be allowed to “opt-out” of network plans contracted through a third party on behalf of a health insurance carrier. During the 2022 legislative session, we filed legislation in the House with Rep. Bishop Davidson (R-Republic) that would enhance the current statute to include an “opt-in” provision, therefore requiring initial contracts between a health carrier and provider contain language explicitly stating the carrier holds the authority to lease out their carrier plan. In 2023, we will re-file this legislation with Rep. Davidson in the House and a new sponsor in the Senate.
Virtual Credit Cards, Add “Opt-In”
In 2019, the MDA worked with a coalition of health care providers to pass legislation to require health insurance carriers utilizing alternative methods of reimbursement (such as virtual credit cards), to notify the provider of initiating/changing such method of payment, and permit the provider to select an alternative payment method (opt-out). Despite this law change, we continue to hear stories from providers who still are being paid via virtual credit cards despite opting out. In 2023, the MDA will file legislation to include an “opt-in” provision. This would require insurance carriers to receive explicit consent from the provider before utilizing an alternative method of reimbursement, such as virtual credit cards.
Remove Delta Dental Exemption
Delta Dental of Missouri has its own statute in state law that defines them as a “pre-paid dental plan” and exempts them from laws regulating all other insurance carriers. Because of this exemption, the MDA has spent significant legislative capitol over the last decade adding Delta Dental to various insurance regulations as new issues arise. Most recently, the MDA passed legislation to include Delta Dental of Missouri under Missouri’s assignment of benefits (AOB) laws. Despite passing this bill with no opposition from Delta Dental, the company refuses to comply with the assigning of a benefit requested by a patient to the provider since the enactment of the law in August 2022.
In 2023, we will file legislation to remove Delta Dental’s special exemption altogether. By removing their exemption in statute, Delta Dental would be under the purview of the Missouri Department of Insurance and subject to the same regulations as other insurance companies, hopefully alleviating future legislative burdens of the Association. Additionally, we will continue to pursue conversations with the Attorney General’s office regarding enforcement of these regulations, especially when a new Attorney General is appointed by the Governor in January.
Appropriations Priorities
We will advocate for full funding for Donated Dental Services and Elks Mobile Dental Services again in the FY24 state budget. Additionally, we look forward to continuing conversations with members of the House and Senate budget committees to maintain this year’s historic increase to Missouri’s Dental Medicaid program.
Our team looks forward to returning to the State Capitol in January for the annual Missouri legislative session to fight for you, your practice and your patients. But the fact remains, we can’t accomplish any of these priorities with you, our members! Advocacy is not a spectator sport, especially when it comes to dental advocacy. Your day-to-day operations, your license requirements, how you are paid and the very care you deliver to your patients is governed by the laws created by our legislators—none of whom are dentists. For more information about the MDA’s legislative successes and goals, and how you can become an advocate for your profession, visit modental.org/advocacy.
I want to thank you, our members, for making these victories possible. Our legislative successes would not happen without your continued advocacy and support of MODentPAC. Our team already is preparing for the next legislative session, and we look forward to continuing to advocate for you. Please also save the dates and plan to join us: February 1, Virtual Town Hall and March 1, Dental Day at the Capitol. Please do not hesitate to contact me with any questions.
Olivia Wilson is the MDA Legislative Liaison and Lobbyist