The most effective way to help make sure Wisconsin families get the oral health care they need is to keep treatment choices between the patient and the dentist.
The WDA again pursued passage of non-covered services legislation in the 2013-14 session (January 2013 through May 2014).
Bill name and status: Assembly Bill 109/Senate Bill 131 non-covered services legislation had 90 bipartisan (45 Republicans and 45 Democrats) co-sponsors in both houses (69 of 99 Assembly members and 21 of 32 Senators) this session.
The NCS bill passed a floor vote in the Assembly April 17 with a final count of 89 to 8 and in the Senate on May 7 with a final count of 30 to 3. Gov. Scott Walker signed AB 109 into law on July 5, 2013.
2013 Act 26 prohibits dental insurers from setting fees for services and procedures not paid for under a patient’s plan. Several WDA leaders, constituent dentists and staff joined legislative sponsors Sen. Jerry Petrowski (R-Marathon), Rep. Joan Ballweg (R-Markesan), her chief of staff and another legislative co-sponsor Rep. John Spiros (R-Marshfield) in witnessing the governor signing the non-covered services legislation into law in his Capitol office.
(Existing New York law prevents NCS capping, which means 34 states prevent the practice but only 33 states have passed stand-alone NCS legislation on margins of 10-to-1 since 2009.)
Objective: Prohibit dental insurers from setting fees for services and procedures not paid for under a patient’s plan.
- Provides for greater transparency in the cost of patient care: The current system forces dentists to absorb losses for non-covered services or to pass losses on to an estimated 50 percent of patients who have no benefits at all. This practice of cost-shifting has contributed to a major lack of transparency in the medical model and is not a fair solution – especially for those who will get stuck paying for someone else’s dental service.
- Provides a fairer business climate for Wisconsin’s small-business dental practices. Lets the marketplace determine a reasonable and competitive fee for services outside the scope of a dental benefits plan.
- The bill only affects services NOT covered by an insurance plan. Services usually covered under the plan will continue to be subject to the plan’s fee schedule.
- Non-covered services laws have passed overwhelmingly in 30 states.
- In many instances, an insurer’s allowed fee for a non-covered service does not even cover the hard cost of providing the service, putting a tremendous hardship on small-business dental practices.
- Dentists cannot join together to collectively seek insurance contract changes due to federal antitrust laws. Ironically, insurance companies are one of the few entities exempt from these laws. While dentists can’t work together for contract changes, insurers can.
- Bipartisan support in both houses.
- $0 fiscal impact on state budget.
2013-14 Legislative Session Co-sponsors
Rep. Joan Ballweg (R-Markesan)
Rep. Peter Barca (D-Kenosha)
Rep. Mandela Barnes (D-Milwaukee)
Rep. Terese Berceau (D-Madison)
Rep. Penny Bernard Schaber (D-Appleton)
Rep. Kathleen Bernier (R-Chippewa Falls)
Rep. Janet Bewley (D-Ashland)
Rep. Garey Bies (R-Sister Bay)
Rep. Jill Billings (D-La Crosse)
Rep. Edward Brooks (R-Reedsburg)
Rep. Fred Clark (D-Sauk City)
Rep. Chris Danou (D-Trempealeau)
Rep. Steve Doyle (D-Onalaska)
Rep. Mike Endsley (R-Sheboygan)
Rep. Eric Genrich (D-Green Bay)
Rep. Evan Goyke (D-Milwaukee)
Rep. Gary Hebl (D-Sun Prairie)
Rep. Dianne Hesselbein (D-Middleton)
Rep. Gordon Hintz (D-Oshkosh)
Rep. Mark Honadel (R-South Milwaukee)
Rep. Brett Hulsey (D-Madison)
Rep. André Jacque (R-De Pere)
Rep. John Jagler (R-Watertown)
Rep. Andy Jorgensen (D-Fort Atkinson)
Rep. Robb Kahl (D-Monona)
Rep. Dean Kaufert (R-Neenah)
Rep. Samantha Kerkman (R-Powers Lake)
Rep. Steve Kestell (R-Elkhart Lake)
Rep. Joel Kleefisch (R-Oconomowoc)
Rep. John Klenke (R-Green Bay)
Rep. Debra Kolste (D-Janesville)
Rep. Scott Krug (R-Nekoosa)
Rep. Mike Kuglitsch (R-New Berlin)
Rep. Daniel LeMahieu (R-Cascade)
Rep. Amy Loudenbeck (R-Clinton)
Rep. Howard Marklein (R-Spring Green)
Rep. Cory Mason (D-Racine)
Rep. David Murphy (R-Greenville)
Rep. Stephen Nass (R-Whitewater)
Rep. Lee Nerison (R-Westby)
Rep. John Nygren (R-Marinette)
Rep. Todd Ohnstad (D-Kenosha)
Rep. Alvin Ott (R-Forest Junction)
Rep. Sandy Pasch (D-Shorewood)
Rep. Kevin Petersen (R-Waupaca)
Rep. Warren Petryk (R-Eleva)
Rep. Sondy Pope (D-Cross Plains)
Rep. Jon Richards (D-Milwaukee)
Rep. Daniel Riemer (D-Milwaukee)
Rep. Janis Ringhand (D-Evansville)
Rep. Melissa Sargent (D-Madison)
Rep. Michael Schraa (R-Oshkosh)
Rep. Katrina Shankland (D-Stevens Point)
Rep. Stephen Smith (D-Shell Lake)
Rep. John Spiros (R-Marshfield)
Rep. Jeff Stone (R-Greendale)
Rep. Patricia Strachota (R-West Bend)
Rep. Gary Tauchen (R-Bonduel)
Rep. Chris Taylor (D-Madison)
Rep. Jeremy Thiesfeldt (R-Fond du Lac)
Rep. Paul Tittl (R-Manitowoc)
Rep. Travis Tranel (R-Cuba City)
Rep. Amy Sue Vruwink (D-Milladore)
Rep. Thomas Weatherston (R-Racine)
Rep. Mary Williams (R-Medford)
Rep. Mandy Wright (D-Wausau)
Rep. Leon Young (D-Milwaukee)
Rep. Jocasta Zamarripa (D-Milwaukee)
Rep. Josh Zepnick (D-Milwaukee)
Sen. Jerry Petrowski (R-Marathon)
Sen. Robert Cowles (R-Green Bay)
Sen. Tim Cullen (D-Janesville)
Sen. Michael Ellis (R-Neenah)
Sen. Jon Erpenbach (D-Middleton)
Sen. Richard Gudex (R-Fond du Lac)
Sen. Dave Hansen (D-Green Bay)
Sen. Nikiya Harris (D-Milwaukee)
Sen. Sheila Harsdorf (R-River Falls)
Sen. Robert Jauch (D-Poplar)
Sen. Frank Lasee (R-De Pere)
Sen. Mary Lazich (R-New Berlin)
Sen. John Lehman (D-Racine)Sen. Mark Miller (D-Monona)
Sen. Terry Moulton (R-Chippewa Falls)
Sen. Mark Miller (D-Monona)
Sen. Luther Olsen (R-Ripon)
Sen. Dale Schultz (R-Richland Center)
Sen. Jennifer Shilling (D-La Crosse)
Sen. Lena Taylor (D-Milwaukee)
Sen. Kathleen Vinehout (D-Alma)
Sen. Robert Wirch (D-Pleasant Prairie)