Advocacy Never Sleeps!
What’s new from MA, NH and VT
L. Jeffrey Lowenstein, DMD
Welcome to the fall season! I know you had a great summer. All the kids are now back in school and all is right with the world. So now you think it is the time to get started on contacting your state senators, state representatives, US congressman and senators to get a “jump” on advocating for you profession and yourselves. Well, you are late to the dance. Advocacy happens 24 hours per day, 52 weeks per year and every moment that computers are buzzing along. Artificial intelligence is at work with most of the advocacy efforts now taking place in the USA, but that doesn’t mean that you can’t participate.
While you were away, here is a recap of the key advocacy issues in Massachusetts and what’s happening in New Hampshire and Vermont:
From the Bay State
- Virtual Credit Cards Legislation (S.704) would require insurers to disclose all associated fees and obtain provider consent before paying via VCCs. Dentists must opt-in to receive payments that way.
- Dental Loss Ratio (DLR): Following a ballot initiative passed in November 2022, dental insurers must now spend at least 83% of premiums on patient care. Reporting to the state’s Department of Insurance began in 2025.
- Patients First Act – Signed December 2024, this law delays implementation until 2027. The MDS is actively working to exclude dental providers from future mandates and clarify regulatory expectations.
- Dental Hygienist Reciprocal Licensure (H.4842): Enacted January 2025, this law allows foreign-trained dentists to more easily qualify as hygienists, helping address workforce shortages.
- Dentist Diversion Program: Integrated into substance use disorder legislation signed in December 2024, this initiative brings a diversion program under the state licensure board to support recovery pathways for dentists.
- Water Fluoridation & Public Health The Massachusetts Dental Hygienists’ Association (MDHA) strongly supports community water fluoridation and opposes legislation like H.2548/S.1517, which would ban artificial fluoridation. Their grassroots alerts urge action on related legislation.
From the Granite State
- Adult Medicaid dental benefit—implementation pain points. NH’s comprehensive adult benefit went live April 1, 2023; state materials continue to stress rollout/operations (benefit design, provider onboarding, utilization). Access remains an advocacy focus.
- Licensure portability (Dentist & Dental Hygienist Compact). SB 187 (2025) to adopt the interstate compact was introduced and re-referred in March—advocates are pushing to keep it moving.
- Hygienist scope/standards. HB 144 (2025) (signed Aug 1, 2025) updates dental hygiene practice—including training/exam for local anesthesia—an operational change practices must implement.
- Federal non-covered services push. NHDS flagged the re-introduction of the federal Dental and Optometric Care Access Act limiting “non-covered services” provisions in dental plans (a payer fairness issue providers watch).
From the Green Mountain State
- Medicaid payment increases and adult cap. VT raised dental reimbursements and increased the adult annual cap to $1,500, effective July 1, 2023 (SPA approved Oct 25, 2023). Emergency dental services are covered after the cap. This is a marquee advocacy win but ongoing work tracks network adequacy and pediatric rates.
- Licensure portability (Dentist & Dental Hygienist Compact). H.47 (2025–26) proposes VT’s adoption of the compact—key for recruiting/retention and surge capacity.
- Dental therapy already authorized. VT has licensed dental therapists since 2016; statute defines scope/supervision and preceptorship. Education pathways have been developed in-state. Advocates continue working on deployment and payer alignment.
- Independent billing by hygienists in specific programs. State guidance notes RDHs can enroll as Medicaid providers for defined services—useful for school-based/802 Smiles settings.
- VSDS public-facing advocacy. Society is actively running “Care Beyond the Chair” and legislative patient-advocacy messaging—good platform for member stories.
Now that you are brought up to date, I need your help by getting to know your local government officials so that you can make a difference in the professional and personal lives of your friends, relatives and fellow members of the greatest profession on earth. If every orthodontist advocated for laws that will make our practices run more effectively and efficiently, the world would be a better place.
As always, I am available to answer your questions and help you with your advocacy efforts. Be well and healthy.
Regards,
Dr. Jeff Lowenstein
metdent@rcn.com