The Virginia General Assembly adjourned on Sunday, February 24^th, after approving amendments to the state budget - a day late after what most everyone agrees was "the longest short session" in recent memory.

The scandals that have engulfed all three of Virginia's top statewide officials have not abated.  Protests are regular occurrences on Capitol Square and the future likely holds a very long and drawn out process. This could damage the Democrats electorally this November as all 140 seats of the legislature are up for grabs, however; several months is several lifetimes in the political world so it will be interesting to see how it all shakes out as Virginia's politicians remain in the national headlines for the foreseeable future.

Our primary task this session was to work on passage of the "Silent PPO" legislation, which the VDA asked Delegate Lee Ware to patron in the House (HB1682).  This legislation passed both the House and Senate and is now on the way to the Governor's desk for his signature. As with all legislation headed his way at this point, he has until March 26th to sign, amend or veto the legislation.  A letter of support from VDA President,  Dr. Sam Galstan, has gone to the Governor's office and we do not expect any issues but will keep you posted.  We thank the many VDA members for their efforts in reaching out to legislators regarding this legislation.

Here is a recap of several other issues on which we worked on behalf of the VDA membership:

• Balance Billing:  As we note prior to session, there was scrum amongst hospitals, physicians and insurance companies regarding balance billing. There were several measures and the focus in the end was on ER docs.  We stayed close to the debate to ensure dentists' ability to balance bill was NOT impacted and after many hours of hearings, debate and tempers flaring, nothing passed.  TBD whether or not this issue will be brought back up next year.

• E-Prescribing: Dentist and Delegate Todd Pillion carried the legislation related to e-prescribing. His bill exempted health care providers who do 25 or less prescriptions per year of no more than 7 days in length.  Otherwise, if dentists and oral surgeons do not meet that requirement - effective July 1, 2020 - any prescription for a controlled substance that contains an opioid will be issued as an electronic prescription.  The bill passed both the House and Senate and is headed to the Governor who is expected to sign it. Here is a link to the legislation: http://lis.virginia.gov/cgi-bin/legp604.exe?191+ful+HB2559ER+pdf

• Telemedicine:  In its original form legislation introduced by Senator Barbara Favola would have allowed any person licensed to practice medicine who is in good standing with the applicable regulatory agency of a jurisdiction that is contiguous with Virginia to provide health care services to patients located in VA through telemedicine. Significant concern was expressed by the American Association of Orthodontists and with the Medical Society taking the lead, we had the language removed - the remainder of the bill was incorporated into another bill that does not impact VDA members - here is the link:https://lis.virginia.gov/cgi-bin/legp604.exe?ses=191&typ=bil&val=sb1221

• Remote Supervision:  Delegate Dawn Adams introduced legislation that allows a dental hygienist employed by the Department of Behavioral Health and Developmental Services to practice under the remote supervision of a dentist employed by the Department - currently only those hygienists employed by the Department of Health can be supervised remotely. The bill also adds mobile dentistry programs operated by the Department for adults with developmental disabilities to the list of remote supervision locations.  We made several amendments to the legislation and worked with the Department of Health Professions to ensure there is no expansion of practice scope for the dental hygienists - simply the same as what is being done with the Department of Health.  The Governor has signed this bill and there will need to be new emergency regs implemented by the Board of Dentistry. Link to the legislation: http://lis.virginia.gov/cgi-bin/legp604.exe?191+ful+HB1849ER

• Volunteer License:  Delegate Kilgore from far SWVA introduced legislation that creates a special volunteer license for limited practice. The bill directs the Board to promulgate regulations to implement the special volunteer license for limited practice. The bill also removes reporting requirements for dentists and dental hygienists volunteering to provide free health care for up to three consecutive days to an underserved area of the Commonwealth (ie, RAM and the MOM Project).  The bill is on the way to the Governor's desk for consideration.  Here is the link:  https://lis.virginia.gov/cgi-bin/legp604.exe?191+ful+HB2184ER 

• Topical Oral Anesthetics – Hygienists: This legislation was carried by Delegate Kathy Tran and supported by the Northam administration - it has passed both the House and Senate. The substance of the bill allows a dental hygienist practicing under remote supervision to administer topical oral anesthetics, topical and directly applied antimicrobial agents for treatment of periodontal pocket lesions, and any other Schedule VI topical drug approved by the BoD. The VDA vetted this legislation in the latter part of 2018 and made amendments prior to it being introduced. Here is a link to the legislation: https://lis.virginia.gov/cgi-bin/legp604.exe?191+ful+HB2493ER 

• Emergency Room Study: A budget amendment pushed by the Oral Health Coalition to review emergency room data related to oral health visits was amended by the budget conferees and is now going to be a DMAS report vs. a stakeholder study.  The intent of gathering the data is purportedly to lay the groundwork for an adult Medicaid benefit for oral health. We are going to make very sure the VDA has input as to how and what data is gathered and how it is interpreted.  Here is a link: https://budget.lis.virginia.gov/amendment/2019/1/HB1700/Introduced/CR/307/9c/

A very busy session to be sure and plenty to focus on moving ahead to include participating in the elections.  We encourage and appreciate your contributions to the VDA PAC, participation in VDA PAC Challenge Fundraisers this spring and summer, and your involvement in all other advocacy efforts!