The Arizona legislature is looking at an Insurance Reform Bill that will allow dental providers to file grievances against insurance companies if claims are denied, delayed or disallowed. 

Alaska’s Medicaid program is having difficulty with processing claims and pre-authorizations. As a result, pediatric dentists are not getting their claims paid and are reducing or eliminating the Medicaid services they provide.

1. A major shared issue between Alberta and BC is the rollout of the Canadian Dental Care Program (CDCP). This new federal initiative, which covers children, seniors, and people with disabilities, has caused confusion and separation within the dental community. Dentists have expressed concerns about their lack of involvement in the program’s development and the heavy administrative burden it imposes. In Alberta, the government has announced that the province will opt out of the CDCP by 2025, citing that healthcare is a provincial jurisdiction. In BC, the BC Dental Association (BCDA) and Canadian Dental Association (CDA) have launched the “Know Before You Go” campaign to address public confusion about the CDCP. They are also pushing for reduced administrative barriers and greater clarity for dentists and patients alike. The government has introduced an alternative claims pathway to help dentists assess whether they wish to fully participate.  Dentists are still subject to the Terms and Conditions of the CDCP via the claim-by-claim option, which some of these terms and conditions remain concerning.  
2. In BC, the recently passed Bill 36 (Health Professions and Occupations Act) has introduced significant changes to the governance of healthcare professionals. It replaces peer-elected boards with government-appointed ones, raising concerns about reduced autonomy and potential government overreach, such as warrantless searches, mandatory mental health assessments, and strict penalties for non-compliance with government regulations.
3. Both provinces are taking steps to improve access to dental care. In Calgary, the Dental Access Network aims to provide affordable dental services to low-income families.  Nationwide, the federal Oral Health Access Fund will launch in 2025, allocating funding over three years to support underserved populations, including Indigenous communities and rural areas. These programs aim to expand access and improve oral health outcomes across both provinces.

California addressed the following topics at the most recent CSPD/CDA Advocacy Day:

1. Virtual credit cards that insurance companies are using to pay dentists.
2. $50 million grant approved for special needs dental clinics.
3. Shortening the pathway to become a dental assistant through licensure through experience.
4. Technical fixes to the new sedation laws which have been detrimental to pediatric dental care.
5. Reinstating and assessing the oral health assessment form to include Pre-K children.

2021 Legislative session

The following bills did not advance in this legislative session:  Bills on eliminating the sale of flavored tobacco products, bills regarding taxation on sugary beverages, and bills on re-instating the adult Medicaid dental benefit. 

Advocacy

Due to COVID-19, the Give Kids A Smile event was cancelled for this year.  Oral health education in Head Start sites was given virtually and the community health event is planned for 2022.

Access to care issues

The University of Hawaii School of Nursing and Dental Hygiene obtained a five year HRSA grant to implement a program for Expanded Function Pediatric Dental Hygienists in which the NYU Langone residency will collaborate with the hygiene students. Hopefully these pediatric dental hygienists will go into the workforce in areas of need such as community health centers and implement the teledentistry program in remote areas.

Other Issues

Five new residents at the NYU Langone Hawaii site have matched and began their program on July 1, 2021. The residency has provided access to care for Hawaii’s children at community health centers on the islands of Hawaii, Lanai, Maui and Oahu for over ten years.

1. Dental Loss Ratio discussions were held with insurance companies this year
2. State Medicaid: Contract going out to bid soon but no significant positive changes are anticipated
3. A decline in providers accepting Medicaid or limiting it in their practices was noted. The state/Medicaid sees how many providers “accept” it on their end but feel that there is no access to care issue

[No Current News]

1. Medicaid patients’ access to care for treatment under general anesthesia continues to be a major obstacle to improved pediatric oral health in the state. Minimallyl available medical and dental anesthesiologists willing to offer services because of low reimbursement rates. Surgerical cases
   are severely backlogged and halted in some cases. One dental surgery center now is doing more by have an in-house surgery dentist providers can refer to and then reestablish for continued care in their respective offices.

2. Nevada is actively recruiting for a representative on the dental board in Nevada.

1. SB 1578 was passed: The Oregon Health Authority (OHA) has been directed to establish and maintain a health care interpreter management system to allow online scheduling of health care interpreters for health care providers and coordinated care organizations, and to process billing and payments for services rendered, and to contract with a nonprofit entity to develop and administer a health care interpreter recruitment and retention program.
   
   
2. Proposal for Water Fluoridation in the city of Hillsboro, OR: A pro-fluoridation advocacy group notified the City of Hillsboro Water Department (HWD) that they planned to file a measure for the November 2024 ballot to fluoridate Hillsboro’s public drinking water supply. The Hillsboro City Council approved a community advisory vote on fluoridation on June 18, 2024, for the November 2024 ballot. The Oregon Academy of Pediatric Dentistry supplied an endorsement letter in favor of water fluoridation in the city of Hillsboro.

Utah is proposing a rule change to allow foreign trained dentists to have licensure by credential with an unspecified number of supervised training hours. The state’s dental professionals are concerned about this proposal and are requesting more clarification.

Legislative issues:

• Dental quality assurance committee working on dental in office sedation guidelines, requirements and permit (no final announcement yet). Infection control (no final announcements yet)
• COVID-19 vaccine can be administered by dentists, currently phase 1A (does not include dentists or dental staff)

State Medicaid:

Report from 11/2019 required “the HCA must submit a report to the Governor, as well as appropriate committees of the Legislature, outlining a plan to improve access to dental services for Medicaid clients. The plan will need to address options for carve-in, carve-out, fee-for-service and other models, and include associated costs.”

Wyoming received a 25% increase in Medicaid fees and are hopeful that more providers will start to accept the insurance.