BILL ANALYSIS Ó
AB 502
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ASSEMBLY THIRD READING
AB
502 (Chau)
As Amended June 2, 2015
Majority vote
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|Committee |Votes |Ayes |Noes |
| | | | |
| | | | |
|----------------+------+---------------------+---------------------|
|Business & |10-4 |Bonilla, Jones, |Baker, Chang, Gatto, |
|Professions | |Bloom, Campos, Dodd, |Wilk |
| | |Eggman, Holden, | |
| | |Mullin, Ting, Wood | |
| | | | |
|----------------+------+---------------------+---------------------|
|Health |11-7 |Bonta, Bonilla, |Maienschein, Chávez, |
| | |Burke, Chiu, Gomez, |Gonzalez, Lackey, |
| | |Nazarian, |Patterson, |
| | | |Steinorth, Waldron |
| | | | |
| | |Ridley-Thomas, | |
| | |Rodriguez, Santiago, | |
| | |Thurmond, Wood | |
| | | | |
|----------------+------+---------------------+---------------------|
|Appropriations |13-3 |Gomez, Bloom, Bonta, |Bigelow, Chang, |
| | |Calderon, Daly, |Gallagher |
| | |Eggman, Eduardo | |
| | |Garcia, Holden, | |
| | |Jones, Quirk, | |
AB 502
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| | |Rendon, Wagner, | |
| | |Weber | |
| | | | |
| | | | |
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SUMMARY: Requires insurance companies to reimburse registered
dental hygienists in alternative practice (RDHAPs) for dental
hygiene care legally provided and covered by insurance, and
clarifies that RDHAPs are authorized to establish corporations.
Specifically, this bill:
1)Exempts professional corporations, rendering professional
services by persons duly licensed by the Dental Hygiene
Committee of California (DHCC), from the requirement to obtain a
certificate of registration in order to render those
professional services, and specifies that RDHAPs may be
shareholders, officers, or directors of an RDHAP corporation,
and that licensed dentists and dental assistants may be
professional employees of an RDHAP corporation.
2)Requires health care service plan contracts covering dental
services, specialized health care service plan contracts
covering dental services, health insurance policies covering
dental services, and specialized health insurance policies
covering dental services issued, amended, or renewed on or after
January 1, 2016, to reimburse RDHAPs for performing dental
hygiene services that may lawfully be performed by registered
dental hygienists (RDH) and that are reimbursable under the
contracts or policies, and would require the plan or insurer to
use the same fee schedule for reimbursing both registered dental
hygienists and RDHAP.
3)Makes other clarifying and conforming changes.
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FISCAL EFFECT: According to the Assembly Appropriations
Committee, 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:
Purpose. This bill is sponsored by the California Dental
Hygienists' Association. According to the author, "A number of
situations reduce access to RDHAPs... [M]any dental insurance
companies recognize dentists in a dental practice as the billable
provider of dental hygiene services and even though RDHAPs provide
the same billable services that an RDH provide, billed by the
dentist, the insurance companies are denying RDHAP's reimbursement
for services. This forces patients who cannot easily access care
in a traditional dental office to pay out of pocket for the
services of a RDHAP or not receive the care due to finances? [The
BPC] authorizes RDHAPs to incorporate. Corporation law would
protect the RDHAP's business, however, there is not language in
the Corporations Code authorizing RDHAPs to establish
corporations, leaving them without critical protections. [This
bill] would address these issues and ensure that the public has
access to quality dental hygiene services."
Background. In 1986, the Office of Statewide Health Planning and
Development (OSHPD) created the RDHAP. In 1993, the professional
designation was made permanent in statute. An RDHAP must have
been engaged in the practice of dental hygiene as a registered
dental hygienist in any setting, including educational settings
and public health settings, for a minimum of 2,000 hours during
the immediately preceding 36 months, complete 150 additional hours
of education courses, and pass a written exam. An RDHAP has a
unique distinction in that they can work for a dentist or as an
employee of another RDHAP as an independent contractor, as a sole
proprietor of an alternative hygiene practice, or other locations
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such as residences of the homebound, schools, residential
facilities, and in underserved dental shortage areas, as
determined by OSHPD. They may also operate a mobile dental clinic
or operate an independent office or offices.
As a result, RDHAPs may practice in settings outside of the
traditional dental office, and allow patients to receive the same
type of professional preventive care they would receive in a
dental office in schools, skilled and residential care facilities,
hospitals, private homes, and in some instances in an RDHAP's own
office. A 2009 survey of California RDHAPs found that more than
two-thirds of their patients had no other source of oral health
care. RDHAPs also struggle to find referrals to dentists for
patients in need of more advanced care and charge lower fees than
dentists.
The DHCC licenses and regulates approximately 509 RDHAPs.
Reimbursement for Services. Currently, many dental insurance
companies recognize dentists in a dental practice as the billable
provider of dental hygiene services and even though RDHAPs provide
the same billable services that an RDH provide, billed by the
dentist, the insurance companies are denying RDHAP's reimbursement
for services. In its 2014 Sunset Review Report, the DHCC
identified as a barrier to RDHAP practice the inability for RDHAPs
to collect payment for services rendered. The DHCC noted that
RDHAPs have difficulty collecting payment for services from
insurance companies based outside of California. This is because
not all states have the RDHAP provider status making them
ineligible for reimbursement. As a result, some patients who
cannot easily access care in a traditional dental office are
forced to pay out of pocket for the services of a RDHAP or not
receive care due to financial constraints.
Professional Corporations. A professional corporation is an
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organization made up of individuals of the same trade or
profession. The Moscone-Knox Professional Corporations Act of
1968 authorized the formation of professional corporations to
obtain certain benefits of the corporate form of doing business,
such as limited legal liability. At that time, only medical, law
and dental professional corporations were envisioned; there are
now 15 authorized healing arts professional corporations. Current
law specifies which healing arts licensees may be shareholders,
officers, directors or professional employees of professional
corporations controlled by a differing profession if the sum of
all shares owned by those licensed persons does not exceed 49% of
the total shares of the professional corporation.
Business and Professions Code Section 1962 authorizes an
association, partnership, corporation, or group of three or more
registered RDHAPs to practice under an assumed or fictitious name
if the association, partnership, corporation, or group holds a
permit issued by the DHCC authorizing the holder to use that name
connection with the holder's practice, as specified. According to
the sponsors, this section was intended to allow RDHAPs to
incorporate to gain the protections afforded by corporation law,
most importantly, protection against personal liability. However,
conforming changes were not made to the Corporations Code. This
bill would specify that RDHAPs may be shareholders, officers, or
directors of an RDHAP corporation, and specify that licensed
dentists and dental assistants may be professional employees of an
RDHAP corporation.
Analysis Prepared by:
Eunie Linden / B. & P. / (916) 319-3301 FN:
0000884
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