July 27 My take on a new Texas bill

May I have your attention?

Fingers poised on my keyboard, I’m trying to formulate exactly what I am thinking at this moment.  Let me take the emotion, frustration and cursing out and see if it helps.  

[deep breath]

My home state of Texas passed a new bill (SB 519) that goes into effect September 1, 2015 that may affect consultants in the dental industry.  A big thanks to my colleague Duane Tinker for the heads-up email blast!  If you do business with Texas dentists, this could affect you.  Keep reading.

Basically, this is the bill.  You must register as a Dental Support Organization (DSO) if you provide two or more of the following services to a dentist: 

(A)  office space, furnishings, and equipment;

(B)  staff employed by the dental support organization;

(C)  regulatory compliance;

(D)  inventory or supplies, including dental equipment and supplies;

(E)  information systems;

(F)  marketing and advertising;

(G)  financial services;

(H)  accounting, bookkeeping, or monitoring or payment of accounts receivable;

(I)  payroll or benefits administration;

(J)  billing and collection for services and products;

(K)  reporting and payment of federal or state taxes;

(L)  administration of interest expense or indebtedness incurred to finance the operation of a business; or

(M)  insurance services.

Basically, the way the bill is written, this pretty much includes all vendors, exhibitors, and speakers.  But, wait, there are exceptions:

(1)  an accountant providing only accounting services;

(2)  an attorney providing only legal counsel;

(3)  an insurance company or insurance agent providing only insurance policies to a business; and

(4)  entities providing only investment and financial advisory services.

Wasn’t this half of the DSO list?  Why didn’t they just leave them out of the bill in the first place?

When registering with the state, the DSOs must provide the following information:

1. the DSOs name and address
2. the name and address of each Texas dentist the DSO has entered into a business agreement to provide two or more business support services
3. the name of the dentist that owns 10% or more of the DSO
4. the name of each person who is not a dentist and owns 10% or more of the DSO
5. a list of all the business support services provided by each dental client.

It is an annual registration that must be filed no later than January 31^st and if you add or discharge clients, you must file a corrected registration each quarter.  Basically, it’s a VISA to provide services to dentists in the state of Texas.

According to the Sponsor’s Statement of Intent, the State Board of Dental Examiners was instructed to survey the dentists and collect information about the DSOs.  And, according to the SSI, the State Board of Dental Examiners can request information of the DSOs.

What the heck?  Some of the wording in the bill affirmed my suspicion that this was an attempt to reign in Medicaid fraud.  Yes, it’s a concern.  I’m not sure why since the state of Texas is one of the lowest ranked providers of Medicaid.  But it is certainly an official someone’s agenda.

If you are a provider of any of the services that is listed in this bill, which pretty much includes all the vendors, exhibitors, consultants that I know, this is what it means.

You have to register all your Texas dental clients if you provide two or more services.  So, limit your service offerings to only two and you will be safe.

And, if you are a dentist, better make sure that your DSO is registered with the state of Texas, or you will be asked to provide that information by the Board.

Sarcasm aside, which has been extremely difficult, I know their intent was not to limit small business consulting firms in the state of Texas.  But it is how it is written.  Period. 

And the monitoring of this program is going to be a nightmare.  What’s the cost?  Is it worth it?

They obviously didn’t talk to any Dental Support Organizations prior to writing this bill about the economic impact of not being able to do business in the State of Texas, unless that’s what they want.  Since this feels they are going after a different fish than my species, why didn’t they write in some parameters, like DSOs over $1,000,000.00 or DSOs providing support to Texas dentists of over $500,000.

A typical DSO does not provide services only for the state of Texas.  I live here but am national in scope, providing only roughly 10% of services MAYBE in Texas.  Most DSOs don’t “live” here and a small part of their client base is here.  But that is irrelevant.  If you provide only ONE dentist two listed DSO services, you must register, according to the bill.

By the way, the bill does not state what they will do with the list of dentists that are having services provided to them.  There is a purpose to gathering that information.

I’ve contacted two House Members, who coincidentally, did not vote for the bill.  I’ve contacted the Texas Dental Association.  I’ve contacted the Association of Certified Fraud Examiners, since I perform dental embezzlement examinations in the State of Texas.  I’ve contacted an attorney for an interpretation for the scope of my business that will be affected.

Why?

It’s a $1000 per day fine if you provide services to dentists under the structure of the bill and do not register. 

Sometimes it seems like they have nothing else to do.  I tried to eliminate all the sarcasm, but sometimes I just can’t.  Beware and check back - I'll keep you posted.