BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                     AB 502


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          Date of Hearing:  May 13, 2015


                        ASSEMBLY COMMITTEE ON APPROPRIATIONS


                                 Jimmy Gomez, Chair


          AB  
          502 (Chau) - As Amended April 30, 2015


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          Urgency:  No  State Mandated Local Program:  YesReimbursable:   
          No


          SUMMARY:


          This bill makes several adjustments to statutes governing dental  
          hygienists.  Specifically, this bill:









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          1)Allows an alternative dental hygiene practice established  
            within a certified dental health professional shortage area  
            (DHPSA) to continue to operate upon removal of the DHPSA  
            certification.


          2)Prohibits health care service plans and health insurance  
            policies that cover dental services issued, amended, or  
            renewed after January 1, 2016, from denying reimbursement to a  
            contracted provider, or to an enrollee if out-of-network  
            services are covered, when the service is performed by a  
            registered dental hygienist in alternative practice (RDHAP).   
            Requires the same fee schedule be used for dental hygiene  
            services, whether services are performed by a registered  
            dental hygienist (RDH) or an RDHAP.


          3)Clarifies RDHAPs are authorized to establish professional  
            corporations.  


          FISCAL EFFECT:


          Any costs to the California Department of Insurance and the  
          Department of Managed Health Care to assess compliance with this  
          bill's requirements are expected to be minor and absorbable. 


          COMMENTS:


          1)Purpose. The author states this bill will remove barriers in  
            existing law for RDHAPs to practice and increase public access  
            to quality dental hygiene services.  These barriers include:  
            (1) Currently, RDHAPs cannot practice in an DHPSAs once they  
            lose certification; (2) RDHAPs are not currently provided with  
            proper financial incentives to provide services, as health  








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            plans and insurers are denying reimbursement for RDHAP  
            services; and (3) there are no current business protections  
            for RDHAPs in statute, though existing law authorizes them to  
            incorporate.  


          2)Background.  RDHAPs are RDHs in the state of California with  
            bachelor's degrees (or equivalent certifications), who have  
            completed a continuing education course in independent  
            practice dental hygiene and passed a licensing examination  
            administered by the Dental Hygiene Committee of California  
            (DHCC). Once licensed, DHCC requires RDHAPs to designate a  
            "dentist of record" for referrals, consultations, or  
            emergencies, after which RDHAPs are able to provide dental  
            hygiene services without the supervision of a dentist to  
            underserved populations in "alternative practice" settings,  
            which are schools, residential and other institutions,  
            residences of the homebound, and dental health professional  
            shortage areas. According to DHCC, there are currently 563  
            RDHAPs licensed to practice in specified alternative settings.


          3)Opposition. The California Dental Association is opposed to  
            this bill, citing concerns about oversight of RDHAPs who  
            continue to practice after DHPSA certification is revoked, and  
            lack of evidence or data to support this proposal.  


          Analysis Prepared by:Lisa Murawski / APPR. / (916)  
          319-2081

















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