At the 2012 Fall House of Delegates, members were presented with the Council on Government Affairs proposed 2013 Legislative agenda. It was presented to the Board of Trustees at the September 14 meetings and the Board has approved these initiatives:
Reinstatement of AHCCCS Adult Emergency Dental Benefit
In 2010, the Arizona Legislature, in an attempt to cut costs in the AHCCCS system, eliminated the Adult Emergency Dental Benefit. This limited benefit provided compensation to AHCCS providers to cover root canal treatment on the 12 anterior teeth, or extractions, both of which were designed to alleviate pain and infection. We all have heard anecdotal information that hospital emergency rooms have more recently been overrun with patients presenting with dental complaints, where most often they are provided with antibiotics and pain medications without resolving the underlying condition.
AzDA has partnered up with the Arizona Association of community Health Centers, and is collaborating with the Association of Health plans to get to the bottom of the costs associated with this increased utilization.
Preliminarily, our research has concluded that for the top three ICD-9 diagnosis codes for oral conditions, hospital charges have increased by 29% since 2009, an increase of $4,723,442. These charges only consist of incidents where the patient was seen and released. In addition, hospital charges for patient admissions due to oral health issues have increased by nearly 40% to a staggering $20.7 million, an increase of over $7 million. This data does not include physician charges associated with these ER visits and admissions.
This year, AzDA will work hard to reinstate this valuable benefit, and address the wasteful use of health care resources and put the benefit, and the treatment on these individuals, in the hands of dentist.
We will work to develop allies in this fight, and hope to use the Central Arizona Dental Society’s Mission of Mercy event on December 7-8 to show Legislators and the Governor the full extent of the oral health crisis among adults in Arizona.
AzDA to partner with Arizona Association of Community Health Centers in seeking reinstatement of the AHCCCS Adult Emergency Dental Benefit. This partnership developed a fact sheet demonstrating how valuable health care resources and state funds are being wasted as more and more patients seek care in hospital emergency rooms. Click here to view the fact sheet.
Use Tax on Clear Aligner products
Several months ago we were approached by a Chandler orthodontist who was visited by a local revenue official and performed an audit on his use of Invisalign products. The audit concluded that this dentist would owe over $36,000 in back use tax. This led to research on how the city would conclude that orthodontic appliances were subject to use tax, and why a use tax was not assessed on typical orthodontic appliances. Without boring you, the research led to a definition of a prosthetic device in Arizona law, and in Department of Revenue regulations that just needs fixing. As a result, we are working with the City of Chandler and the Arizona League of City and Towns to change the law to make it clear that orthodontic appliances should be exempt from use tax.
Retired Dentist Volunteers
Our NADS colleagues asked the CGA to look into the Dental Practice Act to see what we could do to encourage retired dentists to volunteer their services at charitable clinics. We learned that there are already provisions for this in Arizona law and also learned that Arizona law gives a “qualified immunity from liability” for health care providers who render free services.
We also learned that that currently, BODEX requires a retired licensee to do 27 hours of CE in order to renew their license. CGA has proposed that in lieu of CE, a retired licensee should be able to renew upon demonstration that he or she has completed at least 27 hours of community service. Upon consultation with BODEX, we have learned that this change can happen by regulation and will not require a change in the statute.
Business Entities: Unethical Conduct
As you know, in 2008, we were successful in getting legislative approval of a regulatory structure at BODEX for Registered Business Entities. When that law was adopted, one part of the law was adopted that business entities could not interfere with the professional judgment of the licensee performing service for them. We all know that many of our young dentists are often placed in compromising positions where the business entities’ practice interfere with their professional judgment.
Members have reported some outrageous activities, including business people changing or altering treatment plans. To protect dentists in this setting, particularly our younger members, we are proposing that the Dental Practice Act should be amended to add a new category of “unethical conduct” to give BODEX the authority to charge a business entity for interfering in the professional judgment of a licensee.
Support for BODEX Initiatives
Finally, we will be working with BODEX to support some of their initiatives, especially one that would establish a “statute of Limitations” for complaints that will be tied to the period of time that dentists are required to maintain records, which currently is six years.
We understand that BODEX is also looking to revisit the regulation of mobile dentistry practices, particularly the issue of informed consent. We are also exploring whether it makes sense to change laws relating to the privacy of school records, to eliminate abuses by some mobile dentistry providers in getting access to the private addresses and phone numbers of parents to solicit their children for treatment.
We invite you thought on any or all of these initiatives, and I thank the members of the Council on Government Affairs for their dedication and input. This is one of the hardest working of our councils who are always out there looking to protect the profession and watch your back!