FINAL BILL REPORT

SHB 2229

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

C 210 L 18

Synopsis as Enacted

Brief Description: Concerning the applicability of dental practice laws to integrated care delivery systems.

Sponsors: House Committee on Health Care & Wellness (originally sponsored by Representative Macri).

House Committee on Health Care & Wellness

Senate Committee on Health & Long Term Care

Background:

Practice of Dentistry.

Dentists are licensed and regulated by the Dental Quality Assurance Commission (Commission). No person may practice dentistry without first obtaining a license. The practice of dentistry is defined as:

Corporations are prohibited from practicing dentistry or soliciting dental patronage for dentists employed by a corporation. However, a person or entity not licensed by the Commission may:

Uniform Disciplinary Act.

A person not licensed as a dentist, or an entity that is not a professional entity, practices dentistry in violation of the law and is subject to enforcement under the Uniform Disciplinary Act (UDA) if it interferes with a dentist's independent clinical judgment.

Under the UDA, the Secretary of Health investigates complaints regarding unlicensed practice and may issue a cease and desist order and impose a fine of up to $1,000 per day. Unlicensed practice is also a gross misdemeanor for the first violation and a class C felony for subsequent violations.

Federal Anti-kickback Law.

Federal law provides criminal penalties for individuals or entities that knowingly and willingly offer, pay, solicit, or receive remuneration in order to induce or reward the referral of business that is reimbursable under any federal health care programs. The types of remuneration specifically prohibited include kickbacks, bribes, and rebates made in cash or in kind.

Anti-kickback Safe Harbors.

There are safe-harbor protections for certain payment practices and business arrangements that would otherwise be considered suspect under the federal law. If all the conditions of the safe harbor are met, the practices are not subject to criminal prosecution.

The personal services and management contracts safe harbor requires that the following seven standards are met:

The price reductions offered to eligible managed care organizations (MCO) safe harbor provides for several arrangements:

A first tier contractor is an individual or entity that has a contract directly with an eligible MCO. A downstream contractor is an individual or entity that has a subcontract directly or indirectly with a first tier contractor to provide items or services that are covered by an agreement between an eligible MCO and first tier contractor.

The space rental and equipment rental safe harbors require the following six standards:

Summary:

A licensed health service contractor organized as a nonprofit integrated care delivery system may contract for the services of a licensed dentist or employ or contract for the services of licensed dental hygienists, licensed expanded function dental auxiliaries, certified dental anesthesia assistants, and registered dental assistants if the agreement between the parties meets the requirements of following federal anti-kickback safe harbors:

Health carriers may enter into provider contracts or provider compensation agreements with a dentist or dental practice.

Votes on Final Passage:

House

98

0

Senate

49

0

(Senate amended)

House

96

0

(House concurred)

Effective:

June 7, 2018