The 2022 session was one of the MDA’s most successful, including a historic rate increase for dental Medicaid providers.
Friday, May 13 marked the last day of the 2022 regular Missouri legislative session. The infighting amongst Senate Republicans led the upper chamber to adjourn a day early, on Thursday, but the House returned Friday morning to send a few more bills to the Governor. Just 43 non-budget bills passed out of the General Assembly this year. For comparison, the average number of bills passed by the Missouri legislature over the last 40 years is 155. Despite these gloomy circumstances, this session marked one of the MDA’s most successful years. Four of our five legislative priorities made it across the finish line this year. Additionally, we secured a historic rate increase for dental Medicaid providers. Learn more about our legislative successes below.
Assignment of Benefits | We successfully passed legislation that will ensure all types of dental insurance abide to current Missouri Assignment of Benefits (AoB) law. Missouri has an AoB law for all health insurance carriers, but it does not include pre-paid dental plan corporations, such as Delta Dental of Missouri. This passed legislation will ensure all types of dental insurance companies abide by AoB law. Remember, it is still the responsibility of the patient to request benefits be paid directly to the providers; in most instances, that is a simple ask to the patient by the dental provider.
Medical Retainer Agreements (In-Office Dental Plans) | In-office dental plans are a revolutionary development in health care that empower patients to deal directly with the doctor of their choice. These plans provide many of the benefits of a traditional fee-for-service dental plan and traditional dental health insurance plans but cut out much of the red tape. Current laws already allow for in-office plans in medicine—also known as “medical retainer agreements” in statute. However, current laws fail to encompass dental offices and patients. The MDA advocated for and successfully passed legislation to include dentists in current medical retainer laws, therefore allowing Missouri dentists to create and offer in-office plans to their patients. So, for those who had these in place, breathe a sigh of relief, knowing their validity as a plan can’t be challenged.
Credentialing | In 2020, the MDA supported the passage of a new law to improve insurance carriers’ credentialing processes. However, that law was incomplete, as it did not apply to all dental plans offered in our state. This year, we successfully passed legislation to include prepaid dental plans under our current state credentialing statutes. Credentialing laws allow for dental providers to serve patients on an emergency and/or temporary basis within a limited timeframe and include retroactive payments.
Missouri Dental Board Pilot Project | We successfully advocated for legislation that would give the Missouri Dental Board (MDB) the authority to develop pilot projects to extend dental care to under-served populations throughout the state. This legislation will allow the MDB and Office of Dental Health (ODH) to consider flexible ways to extend the oral healthcare workforce to populations that have difficulties utilizing existing oral healthcare facilities.
DHSS Student Loan Program | MDA supported HB2188, a bill by Rep. Jon Patterson, a physician from Lee’s Summit, that would add dental surgery, dental medicine and dental hygiene students to the list of types of students eligible for a loan under the Department of Health and Senior Service’s Medical Student Loan Program. It also raises the loan maximum from $7,500 to $25,000 per academic year. We look forward to learning more about this loan program and how students apply in the coming months.
All these bills have been sent to the Governor for his final signature. All signed legislation goes into effect August 28, unless there is an emergency clause. The new Medicaid rate increases will go into effect at the start of the fiscal year, July 1.
BUDGET & MEDICAID SUCCESSES
In addition to our legislative victories, the MDA successfully secured state funding for several items of interest, most notably a rate increase for Missouri’s dental Medicaid providers:
- MO HealthNet Dental Provider Rates: The FY23 budget includes a historic rate increase for Missouri’s Medicaid dental providers. Reimbursement rates for 2023 Fiscal Year will be 80 percent of the 50th percentile of 2022 UCR rates, which means 80 percent of the average 2022 fees for codes in a particular area. These new rates will go into effect July 1 of this year. We look forward to learning more about the fee schedules from MO HealthNet in the coming months. Read more about this below this article.
- Donated Dental Services: $90,000
- Elks Mobile Dental: $200,000
- Office of Dental Health Fluoridation Pilot Project: $4.7 million
Just like other legislation, the budget goes to the Governor for his final signature. He has the power to veto certain items, but we are confident these items will stay.
Network Leasing | We were unable to get our network leasing legislation across the finish line this year. Currently, a dental insurer may lease or rent out their “in-network” relationship they have established with a dentist to another entity, commonly referred to as “network leasing”. The way the current law is written, insurance carriers are only legally required to notify the dentist after the fact by giving them an “opt out” option. Our legislation would have updated this law to require health insurance carriers, including pre-paid dental plans, gain written consent from the participating provider regarding the leasing or any change to their network plan.
Despite many conversations and back and forth with the dental insurance companies, we were ultimately unable to agree upon bill language that would suit all parties. Such opposition was not unexpected. During the interim, we will continue discussions with interested parties in hopes we can find mutual language ahead of the start of next year’s legislative session.
Thank you all for another wonderful year serving as your Legislative Liaison. Our successes are only possible because of members like you, and your commitment to advancing and protecting this profession.
SAVE THE DATE
The 2023 Virtual Town Hall will be February 1 and Dental Day at the Capitol will be March 1. Place these dates on your calendar!
Historic Missouri Dental Medicaid Rate Increase Passes This Session
We are thrilled to share that on Friday, May 6, the Missouri General Assembly gave approval to one of the largest Medicaid provider rate increases in our state’s history. Reimbursement rates for MO HealthNet dental providers for the 2023 Fiscal Year will be 80 percent of the 50th percentile of 2022 UCR rates, which means 80 percent of the average 2022 fees for codes in a particular area. Just like other legislation, the budget goes to the Governor for his final signature. He has the power to veto certain items, but we are confident these items will stay.
In plain speak, this means rates for Medicaid will be more in line with those reimbursed by private insurance. Traditionally, the Managed Care companies that contract with the State of Missouri to offer Medicaid must also abide by the minimum floor set by the State; therefore, it is likely their rates also will increase to this level. These new rates will go into effect July 1 of this year. We look forward to learning more about the fee schedules from MO HealthNet in the coming months. “This is a huge victory for dentistry in Missouri,” said Vicki Wilbers, MDA Executive Director. “It was built on decades of members’ persistence and advocacy. I can’t thank each of them, and the many oral healthcare advocates, enough.”
With this Medicaid increase, we are sure there will be considerations by dentists to become new providers in the Medicaid system and likely many questions ahead. Look for more information and resources to be forthcoming. In the meantime, ADA CE Online has an on-demand course that may be helpful if you are considering becoming a Medicaid provider: The Ins, Outs and In-Between: How Dental Medicaid Works and How It Can Work for You.