Midway Report – 2014 Louisiana Legislative Session
As of today, the 2014 legislative session is exactly at the halfway point. Here is a brief look at the status of the issues the LDA is working this session:
HB 1 – The appropriations bill is always a focus, even more so when money has been scarce (by government standards). The budget submitted by the Jindal administration was balanced once again with funding sources, especially so-called “one-time” money that raised the ire of many legislators. Such budget sleight-of-hand, which has become common in recent years, does allow for there to be no significant cuts to Medicaid in HB 1 as introduced and an additional $40 million to be allocated for high impact, high earning professional education via the governor’s Workforce and Innovation for a Stronger Economy (WISE) fund. The LSU School of Dentistry (LSUSD) would likely see up to $1 million of the WISE money, so appropriations overall look okay for dentistry so far this session. However, not a single vote has been taken on HB 1 to date, as lawmakers are waiting on updated projections from the Revenue Estimating Conference. HB 1 will likely see MANY amendments in the second half of the session, and it will be a challenge for the LDA to achieve all dentistry’s fiscal-oriented goals this year.
HB 2 – The capital outlay bill, like the appropriations bill, gets a lot of attention each year. Traditionally, legislators invest significant effort into getting projects in their own districts funded via capital outlay. So, the politics can get very intense and confusing. The bill originates in the House Ways and Means Committee, and committee member Rep. Robert Johnson (D-Marksville) has agreed to offer an amendment to HB 2 in that committee. The amendment would provide roughly $4.2 million in funding for upgrades/repairs to the pre-clinical labs and simulation units at LSUSD, a high priority for the LDA this year. However, this bill, like HB 1, has not been moving as legislators wait for a clearer picture of the revenue forecast before acting on these bills.
HB 245 – This was a Louisiana State Board of Dentistry (LSBD) bill that would have allowed the board to charge judicial interest on unpaid fines and costs. The LSBD withdrew the bill after feeling caught in the crosshairs on SB 167 (see below).
HB 475 – This was a Department of Insurance (DOI) bill that was intended to consolidate similar language in the insurance statutes regarding medical discount plans and dental referral plans. When the LDA pointed out that the language wasn’t quite as benign as DOI believed it to be, DOI decided to withdraw the bill and commit to developing a better worded bill for next year.
HB 601 – Initially, this bill would have prevented health care providers from requiring a patient, as a condition of receiving treatment or having the provider file a claim on his/her behalf, to guarantee payment if the insurer did not pay. A key committee amendment took out the part about such a commitment being required before providing services. This essentially neutered the bill. It still LOOKS like a bad bill, but it basically won’t do anything but make providers have to be careful about the exact language in some of their consent documents. The bill’s author is reportedly doing this for a constituent, and appears to believe the bill does something totally different from what it actually does. In any event, he couldn’t be dissuaded from running with the bill, even though it’s kind of a PITA for providers and won’t accomplish anything he SAYS he’s trying to accomplish. LDA would prefer to see the bill die, but we are unlikely to waste political capital fighting an otherwise friendly legislator as long as the bill remains generally harmless. The bill has passed the House and is awaiting a committee hearing in the Senate.
HB 1033 – the bill that creates the WISE Fund. While the actual funding is included in the appropriations bill, HB 1 (see above), the delineation of the how the program would work is in this bill. It clearly would lead to significant funding for the LSU Health Sciences Center (and through LSUHSC, up to $1 million for LSUSD), so it has strong LDA support. It encountered minimal opposition getting through the House, and is currently awaiting a committee hearing in the Senate.
HB 1200 – The Affordable Care Act required each state Medicaid program to establish a Recovery Audit Contractor (RAC) program similar to the one used for Medicare. RACs are specifically charged with identifying overpayments and underpayments to Medicaid providers. Though states have some flexibility in how these are implemented, they are federally required to be paid on a contingency fee basis (i.e., they get paid when State successfully collects overpayments) and to look back at the most recent three years of claims (though no further back). They can also extrapolate based on a “representative sample” of claims to calculate amounts to be recouped for “overpayments” made over the entire lookback period. The manner in which these provisions have been implemented in some other states have raised concerns about this program across the country. HB 1200 would address a few of these concerns and calls for strict accounting for performance. Although we have reservations that most of this bill would be pre-empted by federal law, the LDA has been working with the bill’s author to have it address even more issues with RACs. It has been passed out of committee and is pending before the full House.
HR 47 – This was a House resolution lauding the Dental Lifeline Network’s good work in attaining the milestone of $9 million worth of dentistry given for free to elderly and disabled patients in need. It passed VERY easily.
SB 167 – This bill to re-vamp dental advertising statutes was actually filed on behalf of a large group practice whose owner that felt the current laws left the practice very vulnerable following an incident over “advertising” over which he had no control (the “ad” was done by an insurance company). LDA soon became embroiled in a four-way controversy with the group practice owner (and his attorneys), the LSBD and the senator who sponsored the bill. With the senator insisting on trying to pass a bill in this year’s session, the LDA Council on Governmental Affairs successfully lobbied for revised language that struck a reasonable balance between protecting ALL dental practices from over-reaching advertising laws and creating loopholes through which unscrupulous dentists could drive a moving billboard. The bill passed out of committee and should be heard by the full Senate this week.
Misc. – the LDA has also been tracking legislation relating to assignment of benefits, balance billing, Medicaid expansion and optometrists being permitted to perform surgeries, just to name a few. None of these other issues have advanced to date in a form that would have significant consequence for dentistry.
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