We are just passed the half-way point (aka “Crossover”) in the 2017 General Assembly. The pace of activity, deliberation and action on legislation is always fast and furious during the opening weeks of the General Assembly Session and this year has not proven any different. In fact, many veteran legislators, staff and lobbyists have remarked how this year’s session has been one of the busiest in recent memory. Many of you can attest to the crowded hallways having spent the second Friday of the session in the General Assembly Building during the VDA Day on the Hill.
Aside from addressing the state budget revenue shortfall, legislators have addressed a host of diverse and far-reaching issues such as: opioid and prescription drug abuse, funding for state employees and state troopers, expansion of charter schools and virtual learning, legalizing cannabinoid oil for medical treatments, decriminalizing marijuana possession, gun violence and public safety, non-partisan redistricting, dog hunting and property rights, Airbnb regulations, the use of switchblade knives, solar energy, unmanned systems (drones) and electronic delivery pods, use of handheld devices when driving, as well as the usual focus on taxation, regulations, transportation, education, environment and healthcare. Nearly 3,000 pieces of legislation will have been heard before session adjourns “Sine Die” on February 25, 2017
We have tracked numerous pieces of legislation for the VDA this year and here are just a few the highlights in terms of those that would most directly impact your practice and your patients:
• HB 1474 (Orrock) Dental hygiene; remote supervision
– this was the bill the VDA requested to ensure that last year’s bill on remote supervision captured all agreed upon venues (free clinics, nursing homes, etc.) in which remote supervision could take place and addressed how patients with periodontal disease would be treated. This bill has passed the House unanimously and will pass the Senate this week. To ensure remote supervision can begin sooner vs. later in those that choose to utilize it, we have added an enactment clause to give the Board only 280 days to promulgate any regulations. We will get a letter to the Governor to ensure he signs the bill with no amendments.
• HB 1566 (Webert) Professions and occupations; active supervision of regulatory boards – the origins of this legislation purportedly came from the North Carolina Board of Dentistry case involving the FTC. As originally drafted the bill, among other concerning things, would have given the head of the Department of Health Professions nearly veto power over any regulation – way too much power in the opinion of most stakeholders. After discussing the legislation with us, the MDs, the AG and others, the bill has been amended significantly and creates a staff position in the Division of Legislative Services to review regulations and their necessity for public health and safety on a regular basis.
• HB 2167 (Pillion) Boards of Dentistry and Medicine
– we worked closely with Delegate Pillion, who is of course also a VDA member, on this legislation (and several others) that is an effort to help control the tragic opioid abuse epidemic in Southwest, VA and other parts of the state. Among other things, this bill directs the Board of Dentistry (and the Board of Medicine) to adopt regulations for the prescribing of opioids.
• HB 2225 (Head) Hospital data reporting; charity care and other activities
– this bill was aimed at making sure, especially as more and more consumers are opting for high deductible plans, that hospitals and other healthcare practitioners, are not classifying what is ostensibly bad debt as charity care. The bill would accomplish this by, among other things, requiring the practitioner to develop, post and strictly abide by a clear, consistent charity care policy. Furthermore, the practitioner would be required to report charity care amounts regularly to the Health Commissioner. As originally drafted, the bill captured all dentists and oral surgeons. After explaining to the patron and a few others that VDA members are small business owners and that this policy would put an incredible and unnecessary burden on you, they agreed to make it apply to only those practitioners who have a Certificate of Need (CON) – it is our understanding that very few, if any, VDA members have a CON; therefore, VDA members were effectively taken out of the bill altogether.
• SB 1513 (Wagner) Health insurance; assignment of benefits
– this is a bill that had a companion bill in the House (HB 1813-Leftwich) and both got significantly more legs than most anybody on Capitol Square ever thought they would. Usually the health plans stop these bills quickly in their tracks but this year that task was more difficult. Of course, dentists, unlike the MDs and others, already have the ability to have patients, who have insurance with a network that the dentist doesn’t use, to assign their benefits. And, while neither bill ultimately passed, the issue will be studied by the Health Insurance Reform Commission (HIRC) this summer. It bears close watching to ensure dental provisions remain whole and are not used as a negotiating point for either side should legislation be contemplated in 2018 as a result of the HIRC hearings.
• State Budget
– it is also important to note that despite a budget shortfall north of $1B, reimbursement for the Smiles for Children program and the Missions of Mercy (MOM) program were spared any cuts.
As we frequently mention to you all and others, the Virginia Dental Association is truly a great organization for which to lobby. While the issues are diverse and often complex, the VDA team and the membership continue to set the example for all professions for political engagement. If you have any questions or need additional information, please don’t hesitate to contact us.
Chuck Duvall and Tripp Perrin