State Issues 2022
While the COVID-19 pandemic continued to dominate state legislative activity, states were able to move onto issues that were shelved due to interrupted or delayed 2020-21 state legislative sessions. Much of the 2022 legislative activity centered on recovery from the pandemic and reverting back to pre-pandemic standards. Of note, several states sought to make pandemic-era regulations permanent, including those affecting telehealth, scope expansion for midlevel providers and the ability for more virtual/remote meetings of the government, including those of state Dental Boards.
After delayed activity since 2020 due to the pandemic, state dental boards have been able to turn their attention back to updating anesthesia regulations. Several states proposed or initiated the process of updating their regulations in 2022 with activity expected to continue into the next year. In addition to these procedural requirements, a few public deaths involving anesthesia delivery in dental offices reignited debate on the OMS anesthesia delivery model. A serious challenge stemming from one such incident that would have stripped dentists in North Carolina from the ability to deliver deep sedation/general anesthesia but state leaders and their coalition partners were able to pivot this effort to a more favorable outcome. State societies remain vigilant to suppress such efforts whenever they arise by utilizing resources from AAOMS and knowledge gleaned from previous state society experiences.
Dental insurance reform
State efforts to reform dental insurance operations continue to proliferate in the states, fueled primarily by state dental associations. Efforts center around the National Council of Insurance Legislators' Transparency in Dental Benefits Contracting Model Act – a model bill championed by the ADA – which contains provisions related to network leasing, prior authorization and virtual credit cards. Additional topics addressed by states as a part of this effort also include dental loss ratios, assignment of benefits, downcoding and retroactive denials.
Certified registered nurse anesthetists (CRNAs) were largely afforded independent practice via executive orders during the pandemic to better assist in overwhelmed hospitals. Emboldened by this temporary victory, state CRNA associations sought to make the change permanent during. Of note to OMSs, recent CRNA proposals focus on dental practices by seeking to remove the need for any dentist utilizing a CRNA to hold an anesthesia permit or undergo any office inspection required by the state dental board. CRNA societies also have been quick to criticize the dental anesthesia delivery model in favor of the use of an independent practitioner such as one of their members.