ODA ADVOCACY HITS FULL SPEED
As many of you have heard me say, dentistry is truly a wonderful profession. It offers you and all dentists the opportunity to help people with their smiles and their oral health. Dentists have many career paths available to them, including as a practice owner, employer, employee, faculty member, consultant, etc. Moreover, dentists are well respected and trusted in their communities.
Dentistry is also a heavily regulated profession, and that is not necessarily a bad thing. Dental patients and the general public in Ohio should know that the care they receive from their dentist is safe, effective and consistent with the prevailing standards of the profession and science. Properly crafted laws and regulations can help ensure this. Alternatively, unsound laws and regulations that are not based on sound science or good business or that act to undermine the dental delivery system or the sanctity of the dentist-patient relationship can negatively impact dentistry and undermine the effective and efficient provision of oral health care in Ohio. This is why the ODA’s advocacy efforts are critical.
While dentistry is heavily regulated, especially at the state level, policymakers, including legislators, regulators and other government bureaucrats don’t always have a full understanding of dentistry and dental care. The ODA and its advocacy efforts ensure that policymakers have the facts when they are making decisions that impact on dentistry, the dental delivery system and oral health.
The efforts we have been engaged in this spring provide a perfect example.
Dental Medicaid Reimbursements
In January 2023, after months of prodding from the ODA’s advocacy team, Gov. Mike DeWine had his budget proposal for fiscal years 2024-25 introduced in the Ohio House of Representatives. One of the highlights of the budget bill was a 15% increase in dental Medicaid reimbursements. This was the first proposed significant across-the-board dental Medicaid reimbursement increase in 23 years.
Throughout the spring, representatives from the ODA explained the dire situation created by the neglect of the dental Medicaid system in Ohio for the last two decades in various legislative committees, including the Ohio House Finance Subcommittee on Health and Human Services, the Ohio House Finance Committee, the Ohio Senate Medicaid Committee and the Ohio Senate Finance Committee. Among those who testified with me were the following: Dr. Mark Bronson, a general dentist from Cincinnati who also currently serves as Vice President of the ADA; Dr. Hal Jeter, Vice President of the ODA and a general dentist from South Point; Dr. Vinod Miriyala, a pediatric and public health dentist from the Dayton area who splits time between a private practice and a community clinic; Dr. Kyle Jackson, a pediatric dentist from the Dayton area; and Dr. Matt Messina, who is the Executive Editor of the ODA and on the faculty at The Ohio State University College of Dentistry where he also treats patients at outpatient clinics.
We expressed appreciation for the governor raising the issue of the need to increase dental Medicaid reimbursements but stressed that, after 23 years of neglect, more than just a 15% increase was needed to truly fix the access to dental care problem in Ohio. Each dentist explained how the current system is so underfunded that dentists in Ohio are having to limit the number of Medicaid patients they see because reimbursements are not even covering the cost of overhead to provide the care.
We explained that when patients do not have access to care because of low reimbursements, they present at hospital emergency rooms with dental pain. This is the costliest setting for them to receive care, and in most situations, the emergency rooms only address symptoms like pain and infection through prescriptions for pain medicine and/or antibiotics but the underlying condition is not treated.
We also pointed out the negative impact Ohio’s broken dental Medicaid system is having on Ohio’s most vulnerable patients because poor oral health leads to pain and discomfort, lost school hours for children, lost work hours for adults and reduced job prospects. We also explained the links between poor oral health and systemic health issues, including diabetes, cardiovascular disease and pregnancy complications.
Throughout the spring, we argued that to address access to dental care in Ohio, dental Medicaid reimbursements should be targeted to at least 65% of private dental insurance reimbursements.
As I write this column, the state budget bill has passed the Ohio House of Representatives and is pending in the Senate Finance Committee. Pursuant to the Ohio Constitution, the General Assembly must pass the state budget for fiscal years 2024-25 by June 30, 2023, so keep your eyes out for future updates in the “ODA Today” and our electronic publications, including on our website and social media platforms.
Non-covered Services
Also this spring, the ODA worked to have legislation introduced to address the non-covered services issues. Senate Bill 115, sponsored by Sen. Kirk Schuring (R-Canton), would prohibit dental insurance companies from dictating the fees dentists charge enrollees for services the insurers do not even cover. ODA President Dr. Lori Fitzgerald, a general dentist from Canfield; Past ODA President Dr. Tom Paumier, a general dentist from Canton; Dr. Jeff Tilson, a general dentist from the Columbus area; and I provided testimony before the Senate Insurance Committee on how this tactic by the dental insurers is creating financial hardships for dental offices, unnecessarily interfering with the dentist-patient relationship, and shifting costs onto uninsured patients. We are expecting a vote in the committee this summer, after which Senate Bill 115 would be voted on by the Ohio Senate. A companion bill has also been introduced in the Ohio House of Representatives.
Dentist and Dental Hygienist Licensure Compact
For years, the ODA has had a policy supporting licensure mobility and portability for dentists. In fact, the ODA worked to pass legislation 20 years ago making Ohio one of the first states to require the state dental board to accept the results of all regional clinical testing agency exams, thereby reducing barriers to getting a dental license.
Similarly, the American Dental Association has also supported licensure portability for dental professionals for more than 20 years, and in 2018, it established the Coalition for Modernizing Dental Licensure with the American Dental Education Association and American Student Dental Association. The coalition has since grown to include 120 member agencies. Dr. Joe Crowley, a past president of the ADA and the ODA from Cincinnati, has served as chair of the Coalition.
We know from our surveys of member dentists that in today’s mobile society dental licensure portability is more important than ever.
To establish licensure portability, states can form interstate compacts, which are legal contracts between two or more states that allow them to cooperatively address shared problems while maintaining sovereignty over issues belonging to states. Compacts specifically formed to address occupational licensure in the health professions help facilitate freedom of movement and multistate practice for practitioners, maintain or improve public health and safety, and preserve state authority over professional licensing.
Last year, the Council of State Governments, the U.S. Department of Defense, the ADA, the American Dental Hygienists’ Association, and other interested parties began the process of creating a licensure compact for dentists and dental hygienists.
The Dentist and Dental Hygienist Compact is a legally binding agreement among states that provides a pathway through which dentists and dental hygienists can obtain compact privileges which authorize practice in states where they are not licensed. A state must enact the compact model legislation via a state’s legislative process to join. The goal for organized dentistry is to get all states to enact the legislation so dentists have true licensure portability across the entire country.
Earlier this year, Sen. Kristina Roegner (R-Hudson) introduced Senate Bill 40, which would commit Ohio to the Dentist and Dental Hygienist Licensure Compact. On March 15, 2023, I testified on behalf of the ODA before the Ohio Senate Health Committee in favor of Senate Bill 40, arguing that passing the legislation will create reciprocity among participating states and will reduce the barriers to dental license portability. The ADA has made it a priority to promote passing the compact legislation in other states as well, which will truly enhance dental license portability and mobility for dentists and dental hygienists.
Written copies of all of the testimony discussed above can be found on the ODA’s website, www.oda.org.
ODA Day at the Statehouse
On May 3, 2023, the ODA held its annual Day at the Statehouse event. More than 100 dentists and dental students participated, meeting with legislators and their staff to discuss issues important to dentistry. We discussed Medicaid dental reimbursements, Senate Bill 115 (non-covered services) and Senate Bill 40 (Dentist and Dental Hygienist Licensure Compact) as described above. We also discussed with legislators that only a dentist should be performing irreversible surgical dental procedures on Ohioans and any proposal to create a lesser trained provider (e.g., dental therapists) to perform such procedures is inconsistent with the standard of care we should expect for Ohio citizens.
Dentists know that policymakers can impact their profession, businesses and patients. That is why so many of you value our efforts to protect dentistry and the oral health of your patients. With your support, we will continue to do so into the future.
