Thursday, February 11, 2010
Bill advances to curb forced dental discounts
Insurers wouldn't be able to make demands about noncovered procedures.
General Assembly 2011
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Legislation prohibiting dental insurance companies from demanding discounts for procedures not covered by a patient's policy passed in the General Assembly on Wednesday with broad support.
Senators passed the measure 39-1 with no debate shortly after delegates in the House voted 93 to 5 to approve it.
An unusual coalition of typically powerful lobbies formed in an effort to defeat the legislation, which was proposed by the Virginia Dental Association. Insurance companies, business groups, public employees and the AFL-CIO all urged lawmakers to defeat the bill, arguing that it will stifle competition and drive up costs for services.
The Coalition for Affordable Dental Care has members including Delta Dental of Virginia, Anthem, the Roanoke Regional Chamber of Commerce and the Virginia Association of Counties.
"It's pretty clear that the legislators are not concerned about the cost of dental services for their constituents," said Doug Gray, who as executive director of Virginia Association of Health Plans was one of the early members of the coalition.
Dentists warned that forced discounts harm the quality of dental care and therefore hurt patients.
About 2 million Virginians have dental insurance to cover routine cleaning, fillings and X-rays. However, there are a number of other procedures, such as crowns and implants, that are often not covered by dental policies.
Still, some companies negotiate a lower price for services that are not paid for by the insurance plan. The insurance companies tout these negotiated prices as an added benefit for having the policy. The bills approved Wednesday ban this practice.
Dentists lobbied for the bill because they said if they wanted to be part of the insurance policy's network, they typically couldn't negotiate the contract. But if they refused to be part of the insurance network, dentists risked losing patients. And if they accepted the contract, it affected their bottom line.
Even with broad opposition to the bills, dentists used their political clout to gain supporters. Dentists gave $635,762 in political donations for 2009, including $380,726 given by the dental association, according to the Virginia Public Access Project.
Supporters argued dentists should not be forced to provide discounts on services that insurance companies won't cover. Del. Lee Ware, R-Powhatan County, the sponsor of the House bill, said the discounts required by large insurers such as Delta Dental shift costs to uninsured patients and to insurers that do not negotiate discounts for noncovered services.
"The recession is affecting dentists like it's affecting other folks, and these new contracts are going to add to problems that your dentist already faces in providing quality health care," Ware said Tuesday during a House floor debate on the bill. "If your dental plan thinks that these noncovered procedures are important, they should include them in their covered services."
While the legislation pitted dentists against insurers, Sen. William Wampler, R-Bristol, said his bill was crafted with an eye toward the best interests of patients.
"What I would hope is a lot of these noncovered services become covered," he said.
Dr. Terry Dickinson, executive director of the dental association, said the legislation was about creating a level playing field where insurance companies do not call the shots.
"Let the dentists make that decision to offer discounted rates," Dickinson said. "And they do it every single day."
Dickinson argued that insurance companies were against the bill not because they were looking out for patients but because they wanted to achieve a competitive edge by negotiating deep discounts.
"It's all about business, it's not about patients," he said. "It's simply a matter of bottom line for insurance companies."
The House rejected an amendment proposed by Del. Sam Nixon, R-Chesterfield County, designed to underscore that dentists remain free to offer discounted services to their patients.
"What this bill cuts completely out of the equation and the discussion ... are the patients of the dentists and the customers of the insurance companies themselves," Nixon said.
Both measures apply to contracts entered into, amended, extended, or renewed on or after July 1.
sarah.jones@roanoke.com 981-3264
mike.sluss@roanoke.com 981-3373
