Jan. 2020


By Board Chair Ron Bolden, Cigna

Earlier this month, your NADP Board of Directors and volunteer groups gathered in Dallas for the 2020 NADP Leadership Conference to plan another successful year for the association. To set the tone for the volunteer group meetings, I encouraged attendees to use two elements of Design Thinking utilized by my company when brainstorming: Flare and Focus.  When used in discussion, participants “flare” when they look broadly at new ideas, different approaches and solutions. After thinking big with few limitations, participants shift to “focus” and narrow their thinking to address a particular challenge and develop a solution.

I also presented an overview of the current High-Level Initiatives (HLIs) in the Strategic Plan which was designed for a six-year period ending in 2020, and instructed volunteer groups to provide an update on their progress and evaluate if the High-Level Initiatives assigned to them should be considered for the next plan.

I also provided the Board’s blueprint for developing the next Strategic Plan. The Board has determined it will be most effective to develop the next Strategic Plan in November, after the 2020 federal and state elections. This way we will know the structure of the political landscape and can more efficiently allocate resources toward strategy development. I will share more about the Strategic Plan process through future editions of the Monthlybyte.

With this guidance, NADP volunteer groups held their respective planning meetings and later provided updates to the Board and fellow attendees. Highlights from their group meetings follow.

Advocacy Groups

Commission on Advocacy Policy (CAP) has made tremendous progress on HLI #1, including the repeal of the Health Insurance Tax.  However, there are still many challenges facing the industry. Thus, CAP has identified short-term priorities as proposed federal legislation on Non-Covered Services (NCS) plus proposed model legislation regarding network leasing under consideration by the National Conference of Insurance Legislators (NCOIL) and championed by the American Dental Association. A long-term priority is Dental and Medicare, and CAP is exploring multiple scenarios in order to be prepared to contribute to any discussions on the issue.

Government Relations WorkGroup (GRW) advances HLI #1 by building good relationships with state lawmakers and collaborating with other stakeholder organizations such as the American Council of Life Insurers and America’s Health Insurance Plans. GRW is reviewing its long list of issues, such as leasing and transparency, NCS, reinsurance taxes, and privacy, to create a prioritized, manageable list.

Government Funded Program WorkGroup (GFP WG) supports HLI #1 through both proactive and reactive efforts. WorkGroup goals for 2020 will address the proposed Medicaid Accountability Rule and trends in state exchange waivers affecting how dental is purchased.

Terminology, Standards & Transactions WorkGroups and Sub-Workgroups

EDI WorkGroup supports HLI #4 by working to advance electronic transactions. The WorkGroup provides the dental perspective to the development of electronic data interchange requirements and guides NADP’s work with standards organizations such as HL7. As a special project, they will also continue to provide feedback on the NADP Claims Metrics survey.

Operations WorkGroup contributes to HLIs #3 and #4 by expanding NADP’s scope and influence. Key 2020 projects include:

  • Providing additional feedback to CAQH regarding its credentialing system
  • Promoting broader participation in the Provider Directory Validation Process
  • Exploring consistent delegated credentialing protocols, policy and procedures

Codes Sub-WorkGroup (SWG) completed its review of submissions for CDT-2021 and considered all but one submission. Because the SWG is seen as an industry expert, NADP annually receives the ASCII file of new Codes for review. As a result, NADP members participating in the licensing program receive the new Codes weeks ahead of other carriers.

DQA Sub-WorkGroup supports HLI #2. The SWG has primarily been monitoring measures up to this point and needs to consider or evaluate a stronger proactive position on some DQA measures. To determine next steps, the SWG is outlining a situational analysis and outreach to plans about how or if measures are used.

Diagnostic Terminology Sub-WorkGroup focused on the re-write of HLI #2 in 2019.  The SWG is now working in two tracks:

  1. Buildout workplan to evaluate NADP’s position with regards to requiring and/or using diagnostic terminology on all claims.  Who should make decision about diagnostic codes? Provider groups think it is NADP.  Should it be?
  2. SNOMED Meetings twice a year to continue to monitor and develop terminology that is right for dental benefits industry.  Are plans on the verge of accepting measures and diagnostic codes? How are we working on getting data on outcomes? 


Education Commission supports HLI #3 through the delivery of educational content via CONVERGE and the Webinar Series. For 2020, the Commission will focus on opportunities to promote volunteer outreach programs performed by our members and promote the value of content provided via Webinars.

Research Commission advances HLI #5 and also contributes to others by supporting advocacy and education efforts. The Commission provided details about the surveys it will field in 2020 and encouraged member participation as this enhances the value of the reports.

Additional WorkGroups

Communications WG contributes to HLI #5. The WG plans to add more content to the public facing website, They also discussed the importance of developing content explaining the differences between regulated and non-regulated plans and collaboration with outside organizations, such as the American Association of Kidney Patients, American Diabetes Association and others. The WG also expressed an interest in more collaboration and communications among the volunteer groups.

Membership WorkGroup advances HLI #4 through retention and recruitment of members. The WG discussed membership criteria and possible revisions or additions to include emerging new business models in the industry. They also established 2020 goals to maintain current plan membership and to increase the net gain of Associates and Supporting Organizations by seven members.

As you can see from the brief summaries above, the NADP Leadership Conference was extremely productive. In addition, NADP volunteer groups provide exceptional value to the association and our membership.  On behalf of the Board of Directors and myself, I express my deep appreciation for the work of our volunteers.

Should you have any questions or concerns about NADP, please contact me.


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