HB 1374, Virtual Credit Cards, and Ensuring Providers Get a Fair Shake
Some may wonder why Georgia healthcare providers are talking about virtual credit cards again. Recent events at the National Council of Insurance Legislators (NCOIL), and in other states, suggest that there is an opportunity to improve Georgia law and enable providers to better focus on caring for their patients. States are beginning to move to an opt-in standard for insurance reimbursement by virtual credit card rather than an opt-out standard. They have also adopted other protections to improve provider choice of reimbursement methodology with minimal administrative burden. With these strategies, different jurisdictions have made meaningful improvements that enable providers to focus on what really matters rather than unnecessary administrative headaches. Georgia has the opportunity to do the same thanks to HB 1374.
What Does Georgia Already Require?
Not long ago, legislation added a new section to the Official Code of Georgia Annotated (O.C.G.A.) that governs the use of virtual credit cards, and other forms of electronic payment, when reimbursement is flowing from insurance companies to dentists and physicians. More and more, virtual credit cards, a form of payment which can incur processing fees from 3-5%, were becoming an issue for all healthcare providers, particularly smaller practices, who found the administrative burden to opt-out and/or additional fees to be detrimental to their ability to provide patient care. The result was O.C.G.A. § 33-24-59.24: The new code section said that no insurance plan could contain a contract that would require a provider to receive reimbursement by virtual credit card. It went on to say that insurance companies must notify a provider of fees associated with different payment methods and provide instructions for picking an alternative.
Why Start Talking About Virtual Credit Cards Again?
In this case, the first of interpreters of O.C.G.A. § 33-24-59.24 were the companies seeking to comply with it, and their behavior reflected a range of interpretations. Some companies in Florida and in Georgia elected to require opt-outs from virtual credit cards more than once. Others took steps that restricted methods of reimbursement, or made certain methods more difficult to access. The result was a continuation of the same challenges that created the need for a law governing virtual credit cards in the first place. Fortunately, 6 states have already taken steps to address this problem, and the NCOIL took notice.
Responding to advocacy from the American Dental Association and others, NCOIL updated their Transparency in Dental Benefits Contracting Model Act. The update included language similar to the content of HB 1374, a bill currently waiting on a vote by the Georgia House of Representatives as of this writing. HB 1374 makes several updates to Georgia Code. First, it requires an insurer to get “express consent” for a particular method before sending reimbursement to a provider. The consent would remain in place until a provider chooses to change it. In this scenario, it is conceivable that a given provider could possibly be required to make this choice only once. Furthermore, HB 1374 makes it clear that insurance contracts may not restrict reimbursement methodologies to any form of payment that requires exorbitant processing fees.
Collectively, these changes allow reductions in administrative burden for small practices, and they reduce the costs that could be associated with the simple activity of receiving reimbursement for work completed. These reductions can be channeled into improving the quality and amount of care available. For example, a dentist could use the savings from virtual credit card fees to hire additional hygiene staff, boosting the amount of preventative dental care provided by their practice.
Join Our Advocacy Efforts
GDA advocacy continues all year long. Right now, you can contact your legislator to support HB 1374 and share your experiences with dental insurance. GDAPAC’s annual golf tournament is coming up in May, and advocacy events like legislative receptions and LAW Day happen throughout the year. The best way to stay involved is to sign up to participate in GDA’s Contact Dentist Network. Reach out to our advocacy staff for more information today.