Editor’s Corner August 2019

Report from the 86th Texas Legislature

By Jonathon Kimes, with contribution from The Root and the TDA Legislative Staff

“Free at last, free at last, thank God Almighty we are free at last.”…Dr. Martin Luther King Jr.

This was the resounding cheer heard from the Capitol steps and up and down Congress Ave as your Texas Legislators hopped aboard their rental scooters and headed home after the last gavel fell on Monday May 27.  Sine Die.  The End.  No more bills, no more amendments, no more committee hearings.  The end of the 86th Texas Legislature brought a sigh of relief to all involved, but few were more deserving of a few days off than your TDA Legislative staff.  As they do every session, our amazing TDA legislative team worked tirelessly to push the agenda of protecting our profession and our patients.

With over 10,000 bills filed this session, at one-point TDA was keeping tabs on close to 400.  In the end, it all came down to a handful that had enough momentum to run the gauntlet.

HB1 – The Budget

There was an increase in overall funding for the Texas State Board of Dental Examiners.

Texas Tech University Health Sciences Center at El Paso received $20 million in funding for the Woody L. Hunt School of Dental Medicine. A budget rider attached to that funding authorizes the school to initiate curriculum design, development, and faculty recruitment and other processes necessary to obtain accreditation as a 4-year dental school.

HB 3552 – Water Fluoridation Notice

Representative J.D. Sheffield’s (R– Gatesville) bill requires entities supplying water to the public to disclose to the state and its consumers at least 60 days prior to permanently terminating water fluoridation. This requirement will give the public, and organized dentistry time to respond and mount resistance to any fluoride cessation attempt.

HB 2486 – Insurance Reform

Representative Craig Goldman’s (R–Fort Worth) bill brings much needed insurance relief to dentists. With this bill, dentists and patients will be able to access all of a patient’s dental benefit information via a free web portal; dentists will be able to tell insurance companies how they want to be paid; insurance companies will be prevented from denying dental claims approved by prior authorization; and insurance companies will be prohibited from withholding payment(s) to a dentist because of an alleged “overpayment” to another dentist.

Note: Both HB 3552 and HB 2486 were created as a direct result of grassroots dental society efforts.  These ideas were brought forth by local dental societies during the TDA House of Delegates, and TDA policy was then passed to pursue changes in legislation to address these concerns.  One good grassroots idea, backed by a dedicated and powerful group, and we changed the face of dentistry and dental health for the entire state.  

THAT’S THE POWER OF THE TDA AND DENPAC!

HB 3284 – Mandatory Patient Querying in Prescription Monitoring Program

J.D. Sheffield’s (R–Gatesville) bill delays the mandate for prescribers to check a patient’s Prescription Monitoring Program (PMP) history before dispensing or prescribing opioids, benzodiazepines, barbiturates, or carisoprodol until March 1, 2020. TDA’s legislative staff is already in talks with the TSBDE about opening Chapter 111, Standards for Prescribing Controlled Substances and Dangerous Drugs, to change the TSBDE’s mandatory PMP patient querying date to match the date in the legislation. The bill also creates an advisory committee to suggest improvements for the PMP. The TDA and the pharmacy board are currently discussing dentist representation on the advisory committee.

HB 2174 – Controlled Substances Legislation

HB 2174, by Representative John Zerwas (R–Katy) is the result of combined health care stakeholders’ efforts, including TDA, to create a reasonable measure to help address prescription opioid misuse in Texas. Highlights of the bill include: 

Beginning September 1, 2019, Schedule II controlled substance prescriptions for acute pain are limited to a 10-day supply without refills except in certain situations. However, the bill doesn’t dictate the dosage a practitioner can prescribe to a patient for those 10 days.

All Schedule II controlled substance prescriptions, with certain exceptions, are required to be submitted electronically to pharmacies. This goes into effect January 1, 2021. Exceptions to electronic prescribing for Schedule II controlled substance include, but are not limited to: situations in which electronic prescribing by the practitioner is unavailable due to a temporary technological or electronic failure; the prescribing practitioner has the ability submit an electronic Schedule II controlled substance prescription but determines it’s impractical for the patient and would adversely impact the patient’s medical condition; or a practitioner received a waiver from electronic Schedule II controlled substance prescribing issued by the Texas State Board of Dental Examiners in accordance with the statutory requirements in HB 2174.

Controlled substance prescribers are required to complete 2 hours of continuing education yearly in the prescribing and monitoring of controlled substances.