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Detente reached in dental dustup

An ad war and lobbying campaign over how dentists organize their practices comes to an end as both sides reach agreement over changes to state law.

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RALEIGH, N.C. — A high profile legislative battle – complete with television ads and attention from federal bureaucrats – between various groups of dentists has ended in compromise.

The North Carolina Board of Dental Examiners and the state's Dental Society had been pushing a bill that would limit dentistry management arrangements. Under those agreements, dentists affiliate with companies that handle certain aspects of their business.

Some of those agreements ceded too much power to the corporations, members of the board and society said. They worried that corporate officials based in other states would make treatment and scheduling decisions for the dentists. 

But the dental management companies and dentists allied with them said the board was interfering in private businesses. They said DMAs give younger dentists trying to open a practice and older dentists winding down their work options that lone practitioners don't have.

"The DMA organizations are going to grow," Dr. Alec Parker, executive director of the dental society, said today. "We just want to make sure their growth includes patient protections."

The House Health and Human Services Committee approved a much shorter bill than the society had originally sought. Language in early versions of the bill that would have given the dental board sweeping policy powers -- such as being able to scrutinize business records -- were not included in the compromise bill.

The House passed the measure Wednesday evening, voting 114-0 in favor of the measure. It now goes to the Senate for final approval. 

Existing dental board rules will be allowed to stand, but both sides agreed to create a task force that would recommend changes that would accommodate new business arrangements. 

Representatives from both sides say they expect that task force and the dental board to hammer out a revised set of rules to the liking of all parties and avoid a return trip to the General Assembly.

Over the past several months, both the dental society and the Alliance for Access to Dental Care, a group funded by dental management executives, aired hundreds of thousands of dollars worth of television ads.

Advocates fighting for the bill painted the fight as one that pitted dentists in traditional practices against big corporations funded by private equity groups more concerned with making money than providing quality care. Dental management firms hit back that old-school dentists were trying to limit competition as thousands of North Carolina residents went without affordable dental care. 

Lobbying was intense and involved well known figures in the national Republican Party such as former Florida Gov. Jeb Bush and Grover Norquist of Americans for Tax Reform. In addition, the Federal Trade Commission weighed in, saying the bill first proposed by the Dental Society would have improperly cut down on competition and consumer choice.

"The tensions between both groups will be considerably less," said Tom Fetzer, the alliance's lead lobbyist in Raleigh.

Making the negotiations even touchier was the push and pull between members of the legislature who were dentists and the stated goal of most Republicans to cut back on regulations. 

"It is in the best interest of all parties that the law be clarified," said Rep. Bert Jones, R-Rockingham, a dentist and one of the members tasked with helping both sides find consensus.

In addition to creating a task force, the bill also redefines terms in dental regulations and clarifies how and when the dental board can exercise oversight powers over dentists entering into dental management contracts.  

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