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Entries in WSDA News (69)


Pertussis (Whooping Cough) Epidemic Update

As of July 14, 2012, there were 3,014 reported cases throughout the State compared to 219 reported in the same period last year. More information about our Pertussis epidemic for you and your patients can be found

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Covering the WDS Issue: Keeping you informed!


Being a strong-minded, independent lass, I am always surprised and delighted when someone does something thoughtful for me. It has come to my attention that some of us may have forgotten the thoughtful way WSDA has handled Washington Dental Services reduction in fees.

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The Budget Crisis: WSDA News talks with key legislators

With the state still steeped in a budget crisis of immense proportion, the WSDA news reached out to two key players on the senate’s Ways and Means Committee (the primary fiscal committee for the Washington State Senate, with responsibility for developing operating and capital budgets) — Senator Joe Zarelli (Ridgefield, R), ranking republican, and Senator Ed Murray (Seattle, D), Committee Chair, for their take on the budget and what measures need to be taken, including cuts, revenue and taxes. Both were gracious enough to give us time just before the holiday:
WSDA NEWS: Our members are aware of the significant challenges to the state budget — with another $2 billion to cut, this has got to be a near-impossible task. How do you prioritize which programs and expenses to keep and which to eliminate in the current economic climate?

Senator Zarelli: We’ll have to rewrite the budget enough to close that gap, and while the reductions adopted during the recent special legislative session get us about one-quarter of the way there, the heavy lifting is still ahead because we will have to change or eliminate some of the commitments that were made. Which ones? Well, under Washington’s constitution the paramount duty of state government is to make ample provision for basic education. Whether the state is meeting that obligation is being argued in the courts right now – but it’s safe to expect that K-12 education will continue to receive more money than any other area of government. We have public safety obligations, of course, and I also feel strongly about continuing some level of state assistance to our most vulnerable residents. How much assistance is going to be a key question, and that’s where reforms come in.

Senator Murray: Well, not easily, that’s for sure. It’s very hard to prioritize in this situation, and certainly we’re going to look at where we think we can find efficiencies, where we think we can find savings, where we think we can make decisions that won’t have short-term savings and long-term costs elsewhere. But then, given the dire state of this economy around the globe as well as across the state, we’re left with some tough choices. My hope is that we prioritize those things we can cut, those things that we don’t want to cut, and send those to the voters for revenue. 

Senator Zarelli: I don’t see the 2012 budget rewrite being “all cuts” either. For example, let’s suppose the Legislature finally takes action to address abusive lawsuits that target the state and its “deep pockets” at a cost of tens of millions of dollars each year in defense bills and payouts. The $150 million appropriated in the current budget for such costs represents about 10 percent of the remaining budget gap. The reform of lawsuit abuse could largely if not completely free up those dollars for use elsewhere – which could enable the Legislature to maintain a higher level of assistance to our most vulnerable residents.
  I’m not a dentist, but I provide professional services to clients, so I’ll put the tax-reforms-revenue question in those terms. If I want my business to bring in more revenue for whatever reason, there are three straightforward ways to get there. The first is to raise my rates, which is like government adopting a tax increase. The second is to find ways to reduce the cost of doing business, yet serve just as many clients as effectively as before. That’s “reform” – not as easy as raising my rates, but it produces the same net outcome because it lowers the spending side of my balance sheet. As a bonus, reforms that make my operations more efficient can help me weather any loss of clientele, the same way reforms can help state government get by on less revenue. A third approach is to grow my clientele, without changing my rates or how I do business, so that revenue grows naturally. Government can do the same thing by, for example, streamlining the permitting process for construction projects that create jobs. So if I want my business to bring in more revenue, I’d look at streamlining my costs and growing my clientele before I consider raising my rates – and legislators can also go that route.

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State Health Exchanges: A Federal Perspective

Special to the WSDA News from Jon Holtzee, Director, State Government Affairs at American Dental Association

With the enactment of the Patient Protection and Affordable Care Act (PACA) on March 23, 2010, many questions have been asked and many remain on how the state health exchanges which are required to take effect on January 1, 2014 will impact the accessibility and delivery of dental care in our country. While the answer will vary, depending on the nature of the exchange in each state, there are some things that are certain:
• While the Supreme Court considers the case, work will continue on exchange development;
• States may create discrete individual exchanges and small business exchange or create one unified system;
• Those purchasing through the exchange can do so through the web, by phone or through an insurance agent;
• The only dental benefit required is what’s called the “Pediatric Essential Oral Health Benefit” for those children whose coverage is purchased through the exchange. With the recent announcement by the feds that instead of establishing a national benchmark for that benefit, they will instead permit states to choose between a variety of approved benchmarks. It has become vital for constituent societies to become vocal advocates to be sure the best option is selected for that state;
• If a state declines to submit an exchange plan for approval to Health & Human Services (HHS) by January 1, 2013 for activation on January 1, 2014, the federal government will establish the exchange in that state;
• That despite these deadlines, the federal process for rulemaking and guidance to the states will most likely continue to be painfully slow;
• With over 75 percent of dental coverage being family coverage, requiring only a pediatric benefit may change the dental benefit design and market for those in the exchange; and 
• The law requires that stand-alone dental plans be allowed as qualified plans within the exchange in addition to having a dental rider as an option to a medical plan.
A primary concern in the development of state exchanges is ensuring fair and robust competition among various plans offering dental benefits, and providing a variety of plan models within the exchange. Clearly an exchange that only offered a capitated benefit plan may have a difficult time creating a network of participating dentists to provide care to their enrollees. An example of these difficulties is highlighted by the existing exchange in Massachusetts, where a 2009 study funded by Blue Cross Blue Shield of Massachusetts found that access to dentists continued to be problematic. Only a limited number of providers are willing to accept the Dental HMO offered by Doral, which is the dental vendor for both Mass Health (the Massachusetts Medicaid & CHIP program) and three of the four Commonwealth Care (exchange) plans.

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