The Florida Dental Association (FDA) is advocating for several bills and initiatives that aim to help improve needed dental services and reimbursements for dentists.
FDA President Dr. Beatriz Terry discussed the association’s legislative priorities with State of Reform, which include Senate Bill 892 and its counterpart in the House, HB 1219. SB 892 would prohibit a contract between a health insurer and a dentist from containing certain restrictions on payment methods. Terry said some dentists have faced problems in acquiring payments after performing services.
“This is to ensure our patients get the dental benefits they’re paying for,” Terry said. “Right now there’s an issue with prior authorization. They get turned down for payment after the procedure is done.”
SB 892 would also prohibit a health insurer from charging a fee to transmit a payment to a dentist through an Automated Clearing House transfer unless the dentist has consented to the fee. It would also prohibit a contract between a prepaid limited health service organization and a dentist from containing certain restrictions on payment methods, and prohibit a prepaid limited health service organization from denying claims for procedures in a prior authorization.
FDA also supports increased funding for dental services in Florida’s Medicaid program. Florida currently ranks as one of the lowest in the country for Medicaid program funding. The legislature’s Live Healthy package—which was passed in the Senate and is currently in the House—includes an additional $35 million for Florida’s Medicaid dental program, which both the House and Senate have recommended. Medicaid dental program funding hasn’t increased since 2011.
“We lack providers because the compensation is so low, and administrative costs associated with treating these patients is high, so we’re very much supporting this increase in Medicaid payments.”
— Terry
The association is seeking funding for the implementation of Florida’s Veterans Dental Care Grant Program, which was passed into statute last year. The legislature found that veterans are not afforded dental care after serving in the U.S. military unless they are totally and permanently disabled or have a direct service-connected injury impacting their oral health. Funding for the program would help charitable organizations and clinics across the state provide critical oral healthcare services and treatment to veterans at no cost.
“What many people don’t know is that veterans don’t get dental benefits unless they have an injury to the mouth or are disabled,” Terry said. “This gives them additional funds. We were successful in getting that program passed last year, and this year we’re trying to get the funding ($3 million) for it.”
FDA is also seeking funding to support the Florida Mission of Mercy program, an annual two-day dental clinic hosted by the FDA Foundation to help thousands of Floridians get critical dental care and relief from dental pain. The event is held in a different city each year—previous events have been held in Tampa, Jacksonville, Pensacola, Fort Myers, Orlando, Tallahassee, and West Palm Beach—and has provided more than 13,000 patients with donated dental care valued at more than $13.5 million. It will be held in Lakeland this year, Terry said.
“In the past we had help with legislation approved for $500,000 to support it. So we’re hoping to get it for 2025 as well. We think $500,000 would be helpful for us to continue it. Professionals volunteer their time, and it’s a really big deal. Patients also get a goodie bag with oral health education and information on local dental care resources when they leave.”
— Terry
SB 302 and its counterpart HB 855 would increase patient protections for direct-to-consumer dentistry. The bills would require every dentist—and certain individuals, partnerships, corporations, and other entities—to provide specified information to certain patients. It would also require a dentist to remain primarily responsible for all dental treatments for a patient treated through telehealth.
“We’re hoping the legislature will pass that, which would make it mandatory to provide a dentist of record for a patient to contact,” Terry said.
Terry said the bills would also help promote more recommendations of X-rays for certain patients prior to seeing a dentist, which could help prevent major dental problems.
FDA opposes SB 1254 and its counterpart HB 1173, which would create a new licensed dental provider position called a dental therapist. Unlike the extensive training required to be a dentist, dental therapists are educated for at least three years out of high school and would be authorized to perform surgery or major irreversible procedures like extractions, partial root canals, and administer local anesthesia. FDA believes its dental student loan repayment program provides sufficient resources for rural initiatives, however.
“The FDA does not support this proposal, as it will not provide immediate care and relief for patients and communities in need,” Terry said. “We were successful in implementing the student loan repayment program and getting funding for it. The program is going to pay back loans for those who go to underserved areas. We think that by providing this opportunity to them, we will have the manpower to provide services to these areas, and we don’t need a mid-level dentist to do that. So we’re against both of those.”
As a dental health professional, I am trying to understand why The FDA believes taxpayers should pay $500,000, to support two days a year of “free” dental treatment, by volunteer dentists, hygienists, assistants, lab tech, suppliers and others, to whomever is able to get to a site, which changes each year and provides often “One And Done” procedures.
It may be free treatment for recipients, but it is hard to call it “care,” at least in the sense of continuity and relationship building, which occurs in traditional dental offices, community and school based health centers.
Given the immensity of dental needs, in the state of Florida, it is difficult to believe that FDA is firmly opposed to SB1254 and HB1173, which would enable education of dentist supervised dental therapists, long recognized as safe, competent and effective, in the provision of basic dental care. CODA accredited education, using the exact same standards that apply to dental students, therapists cost but a fraction of what it costs to educate dentists, taught a far broader scope. This makes them an opportunity, rather than a threat.
Alaska and Minnesota have, beginning in 2005, demonstrated the clear benefits to be had, from adding dental therapists to teams led by dentists. There have been no down sides, certainly no evidence with which to support the doomsday predictions FDA leadership has predicted at legislative hearings.
I am not condemning The Mission of Mercy. It is indeed better than nothing. What I do ask is to consider logical and safe alternatives as well, if the purpose is to improve access to care rather than occasional treatment.
How many dental therapists could be educated, in community colleges, for $500,000/yr?
How about encouraging AEGDs and GPRs, in FQHCs and every FL teaching hospital, which educates primary care residents? CMS provides GME Pass Through Funding, covering salaries, benefits and other aspects of education, while nearby communities gain continuity of dental access. This is particularly worthwhile for special needs populations and high risk patients.
FDA leadership needs to look beyond fear. Long term, it will not succeed. Better informing its membership, about how large is the need and how dental therapists, would be effective at improving access.
I cannot understand the objections to HB 1173 and SB 1254 authorizing dental therapy in Florida. 14 states have now authorized dental therapy.
* Despite claims to the contrary, Florida has both a shortage of dentists and a maldistribution with over 6,000,000 people living in Dental Health Professional Shortage Areas and estimates that it would take 1304 dentists to address this shortage. Loan forgiveness is a good short term solution but is very expensive and dentists do not stay in underserved areas after loan forgiveness.
*Despite claims/myths to the contrary, 100% of the published literature around the world and in the USA support the quality, safety, cost effectiveness and improved oral health outcomes of dental care delivered by dental therapists. If opponents have data contrary, lets see it.
*The quality of care provided by dental therapists is assured by the Commission on Dental Accreditation educational standards for dental therapy education; they would not accredit and unsafe profession. This is same body that accredits dental schools.
*The quality of care provided by dental therapists is assured by the fact that they take the same clinical licensing examination as dentists, just limited to the procedures in their scope of practice.
*This legislation does not force dentists to hire dental therapists. But we know from experiences in Minnesota that dentists who hire dental therapists do a social good by improving access to care for the underserved AND they make more money. What is wrong with that?
*I really have to chuckle at the comment by FDA that they do not support this legislation because the dental therapists would not provide immediate relief/care in Florida. Two comments. First, thank heavens the legislature did not have that attitude when they funded the UF College of Dentistry over 50 years ago. That effort took about 8-10 years. Second, Florida dentists could recruit dental therapist to Florida right after legislation passes; I am sure we are an attractive destination for dental therapists from Alaska and Minnesota.
*Final point: READ THE LEGISLATION AND DO THE RIGHT THING FOR ALL FLORIDA RESIDENTS. Join Floridians for Dental Access