HB 564: Assignment of Benefits

MEMBER ACTION ALERT
Please contact your Representative and request his or her support for HB 564, PDA’s assignment of benefits legislation. House Leaders indicate they will schedule HB 564 for a vote in early 2020.  They plan to revert back to the original language in HB 564 (before it was amended by the House Insurance Committee) before it moves to the House floor for a vote.  PDA supports reverting back to the original language requiring assignment of benefits to non-participating providers, upon patients’ request.

Use the talking points below when communicating with your Representative. Log on the General Assembly’s website at www.legis.state.pa.us for your Representative’s contact information. Or contact PDA’s government relations staff at (800) 223-0016 or mss@padental.org for that information of if you have any questions.

Reasons to Enact Assignment of Benefits legislation
HB 564 enhances patient choice and alleviates financial burdens.  Patients can still choose a participating dentist who will accept direct payment in full. Patients can still choose not to assign the benefit to a non-participating provider and pay upfront or work out a payment plan with the dentist.  But the benefit of HB 564 is that patients now have another option—to assign their dental benefit to the non-participating provider, avoiding the burden of paying out of pocket.  This third option will help many of your constituents who face untenable situations based on finances and socioeconomic status, geography and familial circumstances.

A study from the Indiana Health Law Review, found that assignment of benefits laws do little, if anything, to increase health care costs. In fact, ensuring that providers are paid results in them continuing to provide care without having to raise their rates. Another advantage is the elimination of many of the administrative hassles associated with billing and payment experienced by both providers and patients. Click here to access the full study.
 
Insurance companies oppose assignment of benefits laws because they feel this will weaken the participant network. Empirical evidence does not substantiate the claim that provider networks are weakened in states with assignment of benefits laws.  Most recently, a study from Florida after it enacted assignment of benefits legislation found no net loss in physicians’ participation in network plans. Click here to access the full study.
 
Twenty-two other states have enacted assignment of benefits laws.

Dentists are looking to practice in states with a friendly business environment.  Ask any dental student and they will tell you that they factor in a state’s third party payer practices and policies when deciding where to practice dentistry. Currently, Pennsylvania retains less than 30 percent of its dental school graduates because they are seeking employment in other states with fewer insurance restrictions and fairer reimbursement to cover overhead expenses, salaries, etc. Lack of Assignment of benefits legislation is hurting Pennsylvania’s dental workforce capacity.