Vital Times 2017 - 25

to the Senate Business and Professions Committee. CSA
contacted Dr. Cote earlier last year and he was gracious
in his expert testimony to the legislators. Of note, CSA
ultimately went neutral on SB 501 as there were small
gains perceived in the bill as written. The AAP remained
opposed.
Summary: So far, the dental lobby has prevailed. Neither
grieving parents nor common sense expertise could
sway legislators to pass meaningful legislation to enact
patient safety measures that we all take for granted in
our medical (non-dental) world. Nonetheless, this was
not a frivolous exercise. Due to the courage of families
who have suffered tragic losses, and the good work of the
CSA and AAP, the dental community is on notice. The
issue of dental sedation and anesthesia is firmly on the
radar screen and has garnered much interest by the news
media.
The ASA has learned from the CSA experience and is
monitoring the dental sedation discussion in other states.
The ball is now in the CDA, ADA, and CALAOMS
court. At least one California legislator has promised
further action if the dental community does not come
back to the table soon with meaningful data and steps for
safer office-based sedation and anesthesia protocols.
The ASA Statement on Sedation & Anesthesia in Dental
Office-Based Settings was approved at the ASA House of
Delegates Meeting this past October. The ASA Director
of California Linda Hertzberg, MD, FASA, played a
vital role in establishing these recommendations and
promoting patient safety in the office-based setting.

AB 72 OON "Surprise Billing" Law
On July 1, 2017, a new law (AB 72) took effect that
changes the billing practices of nonparticipating
physicians providing non-emergent care at in-network
facilities including hospitals, ambulatory surgery centers
and laboratories. The law, signed in 2016, was designed
to reduce unexpected medical bills when patients go to
an in-network facility but receive care from an out-of-

Samuel Wald, MD, MBA and Jeffrey Poage, MD, with
Assemblymember Catharine Baker (R-San Ramon)

Drs. Paul Yost, Jeffrey Poage, and Mark Zakowski with
Assemblymember David Chiu (D-San Francisco)

network doctor. Please see my summary of AB 72 from
last year's Vital Times: https://www.nxtbook.com/
allen/csvt/2016/index.php#/22
CSA, CMA, and other subspecialty groups (radiology
and pathology) are now engaged with the regulatory
bodies - Department of Managed Health Care (DMHC)
and the California Department of Insurance (CDI) -
are trying to make sense of the new law. For one thing,
we expressed our concern that payors will use narrow
networks to their advantage in determining the ACR
(Average Contracted Rate) calculation. CSA and other
stakeholders prefer volume-driven claims (weighted
data) to determine a more accurate and fair calculation.
Disputed payments and the IDRP (Independent Dispute
Resolution Process) have also been discussed.
Most importantly, the DMHC heard serious anecdotes
of payors using AB 72 as a reason not to renegotiate
(continued)

Annual	Publication	2017	|	 	25
https://www.nxtbook.com/allen/csvt/2016/index.php#/22 https://www.nxtbook.com/allen/csvt/2016/index.php#/22
Table of Contents for the Digital Edition of Vital Times 2017
