Indiana Dental Association’s Department of Government Affairs, as well as the Council on Governmental Affairs, Legislative Issues Committee, and IDPAC continually monitor state and federal legislative and regulatory agencies that affect dental public health and the dental profession. They facilitate communication to and from IDA members regarding Indiana legislative issues and assist the Board of Trustees by recommending legislative and regulatory positions.
Legislative issues currently being monitored include:
1. Dental Recruitment Program
HB 1135, Authors Rep David Frizzell (R-Indianapolis), Rep Charlie Brown (D-Gary)
Often referred to as “student loan forgiveness”, the idea of providing debt relief to dentists who agree to treat underserved patients has been discussed for some time. In 2009, the Indiana legislature established the dental recruitment fund “to provide grants to dentists and dental hygienists to encourage the full-time delivery of dental care in underserved areas and to increase the number of minority dentists and dental hygienists in Indiana.”1 However, the legislature never appropriated monies to the fund so the program never commenced.
Representatives David Frizzell (R District 93) and Charlie Brown (D District 3) have introduced House Bill 1135 (HB 1135) to reintroduce the dental recruitment fund and address several issues that were incomplete in the original bill.
HB 1135 is designed to give student loan relief to dentists and dental hygienists who agree to accept Medicaid and work in underserved areas. It establishes a dental recruitment fee of $10 for hygienists and $20 for dentists to be paid in addition to the license renewal fee. It requires that the recruitment fee be deposited in the Indiana dental recruitment fund.
In order to qualify for an annual grant of $30-35,000, dentists must commit to working four years in a designated underserved area, or as a minority dentist in Indiana, as well as meet other requirements. Dentists will also have the option of serving a fifth year to qualify for an additional grant of $40,000.
Dental hygienists can qualify for an annual grant of $8,000 by committing to work four years in a designated underserved area or work in a clinical setting that serves at least 30% Medicaid patients. Hygienists will have an option to serve a fifth year to qualify for an additional grant of $10,000.
HB 1135 requires dentists and dental hygienists participating in the dental recruitment program to provide an average of 30 hours of services per week. It also appropriates $175,000 from the state general fund to the Indiana dental recruitment fund.
IDA supports HB 1135 and we are encouraged by its chances of passing into law. The bill received a hearing by the House Public Health Committee on Wednesday, January 18, 2017. IDA, along with representatives of the Indiana Dental Hygiene Association and Indiana University School of Dentistry, testified in favor of the bill that passed the committee unanimously 12 to 0. It is now assigned to the House Ways and Means Committee.
There are several areas in which HB 1135 is an improvement over the original bill:
- The original bill required the dentist to provide an approved sliding fee scale for low income patients. HB 1135 removes this requirement.
- HB 1135 requires a hygienist to work in a designated underserved area or in a clinical setting that serves a patient base of at least 30% Medicaid patients. The original bill did not outline hygienist requirements.
- HB 1135 requires a dentist or hygienist to work at least 30 hours in an underserved area. The original bill required at least 40 hours.
- Most importantly, HB 1135 appropriates $175,000 from the general fund into the dental recruitment fund.
There are several steps all IDA members can take to encourage the passage of HB 1135:
- Ask your legislators to support HB 1135.
- Educate Ways & Means Committee members about dental school debt, which may run more than $250,000 upon graduation.
- Thank Reps Frizzell and Brown for introducing the bill.
2. Non Covered Services
HB 1028, Authors Rep Ron Bacon (R-Evansville), Rep Bob Heaton (R-Terre Haute)
Assigned to House Insurance Committee
SB 173, Author Senator Jean Leising (R-Oldenburg)
Assigned to Senate Insurance Committee
Many new dentists or dentists who are not well versed in dental benefits programs are surprised to discover that in Indiana insurers are allowed to require dental providers to give discounts for services not covered under an insured dental plan. If a dentist signs a provider agreement with a dental plan, he or she may be contractually obligated to charge patients no more than the insurer’s maximum allowable fee for services, even the non-covered services.
Indiana is one of only nine states that does not have legislation prohibiting third party payers from limiting what a dentist can charge a patient for non-covered services. Non covered services legislation has been presented in Indiana several times. A non-covered services bill passed out of the Senate in 2013 but never made it to the House. A House Bill was presented in 2015, but never passed out of the Committee on Insurance.
House Bill 1028 (HB 1028) and Senate Bill 173 (SB 173) reintroduce non covered services legislation. The proposed legislation “prohibits dental and vision insurers and health maintenance organizations from requiring dentists and optometrists to accept certain payments unless the health care services are covered under the policy or contract. The bill prohibits dentists and optometrists from charging for noncovered health care services an amount that exceeds the usual and customary charges for the health care services.”2
While the noncovered services argument has been a difficult fight in the past, IDA expects the proposal to receive less pushback this time around than it has in previous years. As it has in the past, the Office of Fiscal and Financial Management expects the bill to have a small impact on the workloads of the Department of Insurance and the Office of the Attorney General. This time, the legislation is being introduced in the House and Senate simultaneously which will hopefully speed up the process. In addition, IDA representatives had the opportunity to discuss the legislation with newly appointed Lieutenant Governor Suzanne Crouch during IDA’s Dental Day at the Capitol on January 25, 2017. As Lt. Governor, Ms Crouch is responsible for small business and economic development, and she does recognize that most dental practices are small businesses. We’re hopeful that this synergy will shine a positive light on non covered services legislation for Ms Crouch.
As of publication, both HB 1028 and SB 173 have been referred to their respective committees on insurance. No further action has been taken at this time.
To help advance non covered services legislation, please:
- Ask your legislators to support the bills.
- Ask Rep Martin Carbaugh, Chariman of the House Committee on Insurance, to give HB 1028 a hearing.
- Ask Sen Travis Holdman, Chairman of the Senate Committee on Insurance and Financial Institutions, to give SB 173 a hearing.
- Thank Reps Bacon and Heaton for introducing HB 1028.
- Thank Sen Leising for introducing SB 173.
3. State Budget
HB 1001, Author Rep Tim Brown (R-Crawfordsville)
The IDA is seeking an increase to a line item in the Indiana State Department of Health (ISDH) budget that funds the Indiana Dental Lifeline Network (DLN). Currently, the ISDH receives approximately $68,670 over the biennium ($34,335 per fiscal year) to subsidize the Indiana DLN which uses these funds to provide donated dental care to elderly and disabled Hoosiers. The DLN would like to increase this funding to $80,000 per fiscal year.
There are approximately 584 DLN volunteer dentists and 144 volunteer dental labs throughout the state of Indiana. Since the program’s inception in 1991, these volunteers have provided over $15 million of dental care to more than 5,000 elderly, disabled, and medically frail low-income Hoosiers.3
Through its volunteers, DLN provides comprehensive treatment that fully restores health, hope and dignity. Services are provided directly in the volunteers’ offices, which makes the DLN program cost-effective and efficient. As a result of these efficiencies, for each $1 given to DLN, $8.87 is provided in life-transforming dental care.4
DLN originally received state funding of $100,000 per biennium beginning in 1999. Throughout the years, budget reductions and inflation have caused reappropriations resulting in the current funding level. The requested appropriation of $160,000 for the biennium would translate into approximately $1.5 million of dental care for Indiana residents, more than 50% of the total care provided by DLN.
IDA member Dr. Bill Risk has met with Senate fiscal leadership and Rep. Sally Siegrist to promote this adjustment to the State Budget.
To support the $80,000 annual budget appropriation for Dental Lifeline Network:
- Contact your State Senator and ask him or her to support the line item increase.
- Contact your State Representative and ask him or her to support the line item increase.
- Educate members of the House Ways & Means Committee on the importance of dental health to overall health.
Important Links & Contact Information
Dental Recruitment Program
- Indiana House Bill 1135: https://iga.in.gov/legislative/2017/bills/house/1135
- Representative David Frizzell: http://www.indianahouserepublicans.com/members/leadership/dave-frizzell
- Representative Charlie Brown: http://indianahousedemocrats.org/charlie-brown/
- IN House Ways and Means Committee: https://iga.in.gov/legislative/2017/committees/ways_and_means_2200
Non Covered Services
- Indiana House Bill 1028: https://iga.in.gov/legislative/2017/bills/house/1028
- Indiana Senate Bill 173: https://iga.in.gov/legislative/2017/bills/senate/173
- Representative Ron Bacon: http://www.indianahouserepublicans.com/members/general/ron-bacon
- Representative Bob Heaton: http://www.indianahouserepublicans.com/members/leadership/bob-heaton
- Senator Jean Leising: http://www.indianasenaterepublicans.com/senators/general/jean-leising/
State Budget / Dental Lifeline Network Funding
Indiana House Bill 1001: https://iga.in.gov/legislative/2017/bills/house/1001
IN House Ways and Means Committee: https://iga.in.gov/legislative/2017/committees/ways_and_means_2200
Find Your Legislators
- Indiana General Assembly: http://iga.in.gov/legislative/find-legislators/
- House Enrolled Act No. 1573, An Act to amend the Indiana Code concerning professions and occupations. First Regular Session 116th General Assembly (2009) retrieved from http://www.in.gov/legislative/bills/2009/HE/HE1573.1.html.
- Fiscal Impact Statement, LS 6284, Bill Number: HB 1028, Office of Fiscal and Management Analysis, prepared Dec 6, 2016, retrieved from https://iga.in.gov/legislative/2017/bills/house/1028#document-69b452f1.
- Dental Care Program Options in Indiana | DDS | DLN. (n.d.). Retrieved January 31, 2017, from https://dentallifeline.org/indiana/.
- July 2014 – June 2015 Annual Report [Pamphlet]. (2015). Dental Lifeline Network Indiana.