2018 Indiana Legislation Affecting Dentistry
Several bills were passed during the previous legislative session that will have an impact on Hoosier oral health and how you practice dentistry. The following enrolled acts went into effect July 1, 2018:
Senate Enrolled Act 221 Use of INSPECT Program
Beginning January 1, 2020, all health care practitioners are required to obtain information about a patient from the INSPECT data base before prescribing an opioid or benzodiazepine to a patient. A practitioner’s agent may act as a delegate and check INSPECT program reports on behalf of the practitioner.
SB 221 further states that a practitioner who checks the INSPECT program for the available data on a patient is immune from civil liability for an injury, death, or loss to a person solely due to a practitioner:
- seeking information from the INSPECT program; and
- in good faith using the information for the treatment of the patient.
The complete transcript of SB 221 is available at http://iga.in.gov/legislative/2018/bills/senate/221.
Senate Enrolled Act 223 PLA Workforce Survey
Beginning with the next licensure renewal in 2020, specified licensed health practitioners, including dentists, are required to take a quick survey upon licensure renewal. This survey, which was previously optional, asks for certain information related to the practitioner’s specialty or field of practice, the practitioner’s work with Medicaid patients, average hours worked weekly, health care services provided and the practitioner’s education background and training.
The Professional Licensing Agency (PLA) will then compile the information and submit the report to the office of Medicaid policy and planning, the department of workforce development, the commission on improving the status of children, the legislative council, and the office of the attorney general. The report will also be made available at the PLA website.
The complete transcript of SB 223 is available at http://iga.in.gov/legislative/2018/bills/senate/223.
Senate Enrolled Act 225 – Opioid Education
Beginning with this current licensure period, every healthcare provider who holds a CSR license will be required to complete two hours of approved continuing education addressing the topic of opioid prescribing and opioid abuse. This two hours is included in, not in addition to, the currently required 20 hours. This CE requirement will expire July 1, 2025.
The Indiana Dental Association is working with the Indiana State Board of Dentistry to outline the specific course requirements and delivery methods. More information on approved opioid continuing education course(s) is expected to be available soon.
The complete transcript of Senate Bill 225 is available at http://iga.in.gov/legislative/2018/bills/senate/225.
House Enrolled Act 1116 – Dental Hygienist Access Practice Agreements
HEA 1116 adds a new chapter to the practice act allowing a dental hygienist to practice dental hygiene in a location and without supervision under an access practice agreement with an access practice dentist.
Under an access practice agreement, a dental hygienist may provide preventive dental hygiene services directly to a patient without a prior examination, presence, or authorization of the access practice dentist if:
- The dental hygienist is licensed under IC 25-13-1.
- The dental hygienist has at least two thousand (2,000) documented clinical hours of dental hygiene services during two (2) years of active practice under the direct supervision of a dentist.
- The dental hygienist obtains and maintains a national provider identifier number.
- The dental hygienist and licensed dentist have entered into an access practice agreement that:
- must be in writing, dated, and signed by the dental hygienist, the access practice dentist, and a representative of the setting where the access practice services will be performed.
- must contain protocols prepared by the access practice dentist and dental hygienist to be used by the dental hygienist when treating patients.
- must be reviewed by the dental hygienist and access practice dentist at least every two (2) years and signed and dated when the agreement is reviewed.
- must be kept on file by the hygienist and dentist while the agreement is active and for two (2) years after cessation of the access practice agreement.
- must be provided to the board upon request.
- The dental hygienist maintains liability insurance that meets certain requirements.
- Before providing dental hygiene services to a patient under an access practice agreement, the dental hygienist has obtained a signed consent form that includes specific information.
- The dental hygienist has met any other requirements of SECTION 2. IC 25-13-3.
HEA 1116 also requires an access practice dentist to be available to provide emergency communication and consultation with the dental hygienist; establishes record keeping requirements; requires that certain written information be provided to the patient or the parent or legal guardian of the patient after providing dental hygiene services; requires patient records to be transferred to the access practice dentist when an access practice agreement is terminated among other requirements.
The complete transcript of House Enrolled Act 1116 is available at http://iga.in.gov/legislative/2018/bills/house/1116#document-480ed602.
General Assembly Considers IDA Legislative Package Proposals, Moves on Opioid Measures
01/19/2018 The Indiana General Assembly is off to a quick pace. Two IDA-supported bills have already received legislative committee hearings:
HB 1049, authored by Rep. Denny Zent, would require dental insurance companies to annually report their claims loss ratios to the Indiana State Department of Insurance, and for the Department of Insurance to make the information available to the public. IDA testified that the requirement could be a helpful tool to employers, allowing them to assess if insurance companies were making efficient use of the employer’s premium dollars. The House Insurance Committee listened to testimony, but as of yet has taken no action on the bill.
HB 1116, authored by Reps. David Frizzell, Denny Zent and Robin Shakleford, unanimously passed out of the Public Health Committee on Wednesday. The bill, supported by both the IDA and the Indiana Dental Hygienists Association, would allow for dental hygienists to provide preventive hygiene services without the direct supervision of a dentist in non-private practice settings. The intent is to allow hygienists more flexibility in providing preventive services in public health settings. The measure passes to the floor next be considered by the full House.
SB 183, authored by Sen. Jim Merritt, would amend Indiana’s current definition of the practice of dentistry to reflect broader model language recommended by the ADA. IDA has been working to secure a hearing for this measure.
IDA is monitoring a number of other legislative initiatives affecting dentistry, many related to the opioid epidemic.
- SB 225 would require all health care prescribers of narcotics to receive two hours of CE in opioid prescribing and opioid abuse.
- SB 221 would phase in INSPECT participation requirements between July 1, 2018 and July 1, 2021. By 2021 all practitioners would be required to consult INSPECT prior to prescribing an opioid.
- HB 1131 would mandate specified patient education before a health care provider could prescribe an opioid drug.
Both SB 221 and SB 225 have passed committee.
While supportive of well-intended efforts to address the opioid crisis, IDA is concerned that over regulation could have unintended consequences. We will be closely monitoring these bills and amendments. Watch for future updates.
Ready to Make an Impact?
Register Now for Dental Day at the Capitol. Indiana legislators will be making decisions on these issues and others that impact your practice. Dental Day gives you the opportunity to meet these legislators face-to-face, introduce yourself to their staff members, and share information on what matters to dentistry. This is the single most effective way for you to have an impact on the political process and advocate for Hoosier oral health.
IDA Legislative Preview 2018
The Indiana General Assembly reconvened January 3rd for the 2018 short session. Although no bills have been given numbers at this writing, the IDA will be pursuing three legislative initiatives.
Hygiene Access Agreements
Representative David Frizzell will introduce legislation creating access agreements for hygienists. If passed, this legislation will allow dentists to enter into written access agreements enabling hygienists to provide preventive services in settings other than a private dental practice. The IDA and the Indiana Dental Hygienists Association have been working collaboratively to craft this proposal.
Dental Insurance Loss Ratios
We are also pursuing legislation that will require dental insurers to report the loss ratio of insurance plans. This will make the amount of premiums vs. the clinical care paid out to patients transparent.
Definition of Dentistry
Senator Victoria Spartz will introduce legislation that will adopt the ADA standard definition of dentistry. This will be the IDA’s second attempt to adopt this language.
We will be monitoring any legislation that will impact your practice as it pertains to controlled substances prescribing. In addition, we expect an attempt to raise the age to purchase tobacco products from 18 to 21.
Thanks to all of you who responded to the ADA alerts on the recent tax legislation that passed in Congress. Your voice mattered. If you would like to become a contact for your state legislator or member of congress, please email Ed Popcheff at email@example.com.