SENATE BILL REPORT

SB 6319

As Reported By Senate Committee On:

Health & Long-Term Care, February 4, 2004

Title: An act relating to participation of denturists in preferred provider networks.

Brief Description: Allowing participation of denturists in preferred provider networks.

Sponsors: Senators Deccio, Thibaudeau, Winsley, Keiser, Franklin, Eide, Esser and Prentice.

Brief History:

Committee Activity: Health & Long-Term Care: 1/21/04, 2/4/04 [DPS].

SENATE COMMITTEE ON HEALTH & LONG-TERM CARE

Majority Report: That Substitute Senate Bill No. 6319 be substituted therefor, and the substitute bill do pass.

      Signed by Senators Deccio, Chair; Winsley, Vice Chair; Brandland, Franklin, Keiser and Thibaudeau.

Staff: Jonathan Seib (786-7427)

Background: A denturist is a person licensed to make and maintain a denture. Under current law, health plans covering dental care are required to cover the services of a denturist if such services would be covered if performed by a dentist.

Some health plans utilize a preferred provider network, paying a larger portion of the treatment costs if the enrollee chooses to use certain providers. There is concern that denturists are being systematically excluded from these preferred provider networks.

Summary of Substitute Bill: Health carriers must allow denturists to participate in any preferred provider network to the same extent, and under the same terms and conditions, as dentists. This does not apply, however, to health care service contractors or health maintenance organizations that employ one or more denturists and contract with a group dental practice on a reciprocal exclusive basis.

Substitute Bill Compared to Original Bill: The substitute bill adds the exemption for certain health care service contractors and health maintenance organizations.

Appropriation: None.

Fiscal Note: Not requested.

Effective Date: Ninety days after adjournment of session in which bill is passed.

Testimony For: The effect of this bill is that insured dental health patients, who are often low or moderate-income elderly, will be able to receive the same reimbursement whether they receive services from licensed dentists or licensed denturists. The only reason for denying preferred provider status for denturists is to discourage patients from seeing denturists for dentures. Denturists have proven themselves to be a worthy addition to licensed providers in this state, and should not continue to be discriminated against in reimbursement policies.

Testimony Against: The savings to consumers from this bill are not as great as proponents suggest. Services received from a dentist reflect the greater amount of training a dentist has. This bill would establish an inequity between preferred-provider denturists and non-preferred provider dentists. Bylaws of the Washington Dental Service would have to be changed if this bill passes, which will cost money to do. Being a preferred provider also imposes responsibilities of which denturists may not be aware.

Testified: Barney Speight; PRO: Steve Wehrly, Val Charron, Washington Denturists Association; CON: Denny Eliason, Dr. Max Anderson, Washington Dental Service.