03 June 2023

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Texas Dental Association secures historic legislative victories

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According to the Texas Dental Association (TDA), it’s often said that Texas’ legislative system is designed to kill legislation, not pass the measures. Approximately 13% of bills filed are on their way to Governor Abbott, as reported by the association, which released a summary of dental-related legislation considered this year. 

The TDA said it’s a true testament to the group’s advocacy power that the association’s priority legislation made it through this difficult legislative session. 

Insurance legislation benefits Texas dentists, patients

TDA’s historic insurance legislation – HB 1527 – is one of the measures headed to the governor for his signature. 

The legislation creates reasonable procedures and a 180-day timeframe for insurance companies to engage in payment recovery efforts. It also prevents insurers from both denying a dental benefit and prohibiting the dentist from collecting fees associated with the dental services provided.

In addition, the legislation creates transparency for dentists and patients by requiring insurers to follow fair and accurate network leasing laws, which allow dentists to review contracts and decide whether to opt-out before an insurance network is leased. 

According to a previously released Senate Committee review report on HB 1527, dentists across Texas have raised concerns that state law governing dental insurance is inadequate and lacks clarity with respect to the recovery of overpayments, clauses that disallow dentists to bill for services and third-party access to provider network contracts with dentists. The measure aims to promote fairness and transparency by limiting the circumstances for overpayment recovery, prohibiting disallowable clauses in contracts with dentists and establishing clear requirements for third party access.

Dental hygienists to administer local anesthetic

Following many years of negotiations between the TDA and the Texas Dental Hygienists’ Association, HB 3824 is en route to Governor Abbott. 

This bill will allow Texas dentists to delegate — under direct supervision to properly educated and trained Texas-licensed dental hygienists — the administration of local infiltration anesthetic to a non-sedated or nitrous oxide/oxygen inhalation sedated patient who is 18 years of age or older in the context of delivering hygiene services. 

The Texas State Board of Dental Examiners will soon start writing the rules establishing the minimum standard of care for dental hygienists administering local infiltration anesthesia. The board will also create the education program and certification examination mandated in the legislation. 

TDA-backed MEWA bill triumphs

The association supported HB 290, which was signed into law by Gov. Abbott on May 23, 2023. This legislation expands Multiple Employer Welfare Arrangements (MEWA) eligibility to sole proprietors and professional organizations if those in the MEWA are in the same state. MEWAs are the basis for group health coverage offered through association health plans. 

TDA Perks’ insurance vendor is currently researching potential MEWA healthcare options for TDA members, their families and staff. 

Dentists to get relief from overbearing patient billing requirements

On May 29, the governor signed SB 490 into law. TDA was able to negotiate dentists out of onerous itemized billing requirements so that the legislation as passed focused on its original intent of making hospitals provide itemized bills to patients upon request. 

Licensure compact bill deserves additional study 

At TDA’s recommendation, the legislature agreed that more study is necessary to make an informed decision on whether Texas should participate in the Dentist and Dental Hygienist Interstate Licensure Compact. The compact creates a legal agreement among participating states establishing pathways for dentists and dental hygienists licensed in a participating state to practice in another participating state in which they are not licensed. 

Given the compact’s complexities and legally binding requirements, the legislative interim gives Texas and interested dental stakeholders additional time to study all aspects of the compact before possibly considering legislation in 2025. 

Other measures considered

TDA had an overwhelmingly successful legislative session, but issues such as limited time, differing political dynamics and a constantly changing legislative atmosphere contributed to Texas lawmakers failing to act on several of the association’s legislative priorities. 

This includes:

• TDA advocated for an increase in Medicaid dental fees, but the odds were stacked against the organization’s success, given that the state is fiscally conservative. TDA said that in the early days of the legislative session, key leaders made it clear that they would not support any new budget items resulting in ongoing increases to the state’s budget.
  
  
• Senator Lois Kolkhorst’s (R—Brenham) clear aligner bill, SB 384, never received a hearing in the House Public Health Committee. In a late session move, Kolkhorst amended Representative Four Price’s (R—Amarillo) telehealth bill – HB 1771 – requiring health care providers, including dentists, to perform an in-person physical examination before initiating an irreversible medical (including dental) procedure. The bill passed the Senate, but the House refused to concur with the Senate’s amendments before the clock ran out on the session. As written, SB 384 would prohibit a person from selling a clear aligner to a patient in Texas or providing a service related to the design or manufacture of a clear aligner unless the person is a dentist who has provided the services prescribed to the patient or receives written or electronic confirmation from a dentist who has provided the services prescribed to the patient.
  
  
• Competing legislative budget priorities prevented TDA from reinstating state funding to Texas’ Dental Education Loan Repayment Program (DELRP). Based on Texas workforce data, there is not a lack of actively licensed dentists, but a maldistribution of where those dentists practice. The Texas legislature eliminated funding for this successful program in 2013. Up until that time, dentists participated in the DELRP and were practicing in underserved locations providing dental care to Texans in need. TDA plans to help dental students alleviate debt by advocating in 2025 to reinstate DELRP funding. 

Learn more on the TDA's website: https://www.tda.org/home