This California lawmaker takes aim at SmileDirectClub


California Assemblyman Evan Low is not what most people would consider anti-tech.

A Democrat from Campbell, Calif., Low represents several Silicon Valley towns and bedroom communities in the state legislature, including Cupertino, the hometown of Apple Inc. AAPL,
He also served as campaign co-chair for former presidential candidate Andrew Yang, and before the pandemic sidelined him, he introduced a California basic income bill inspired by the “freedom dividend.” universal of Yang.

“I represent Silicon Valley,” Low told MarketWatch in an interview. “I’ve always supported the tech economy.”

But over the past year, he has become one of the few lawmakers willing to take on the controversial and contentious teledenistry company SmileDirectClub Inc. SDC,
Low has already drafted legislation signed last October by California Governor Gavin Newsom that included new protections for those who use consumer dental products. Now he supports another new bill with added protectionsbut which, in the age of COVID-19, had to be amended to recognize that in-person dental visits cannot be mandatory.

SmileDirect has been known to fight its battles with critics through the legal system. In May, SmileDirect — which makes lower-cost, self-applied aligners for mild to moderate tooth positioning issues — filed a $2.85 billion defamation lawsuit against NBC News for investigation in consumer complaints about the company. In this story, Comcast Corp.’s CMCSA,
NBC interviewed two patients who said they thought SDC aligners caused tooth and/or bite problems and caused other problems, such as headaches for one patient.

SmileDirectClub called the NBC story a “hit piece” that ignored data on patients’ lack of credibility, such as one’s criminal record and the other’s failure to follow instructions, and ignored the opportunity to interview patients satisfied with their aligner results. NBC told the Wall Street Journal it stands by its reporting. In its longer online version of the story, NBC included comments from four patients who had positive experiences.

In its lawsuit against NBC, SmileDirectClub mentioned Low, saying that NBC omitted from its report “the bias of members of Congress who wrote to the FDA and FTC and the state representative (Evan Low) implicated in the California regulations discussed,” which the lawsuit attributes to “financial ties to dental organizations and physicians who attempt to block teledentistry, in general, and the SDC, in particular.”

Low began to tangle with the company last year when he sought an ongoing status review from the California Dental Board, which regulates licensed dentists in the state. Low and his team learned from the mail about consumer issues and complaints about using self-applied aligners, and dug a little deeper, he said in an interview with MarketWatch.

He believed there needed to be more protections in place for consumers, some of whom said they had to sign nondisclosure agreements in order to receive reimbursement for SDC’s treatment plans, which cost less than metal braces or plastic aligners provided by orthodontists.

“We found there could be additional harm to consumers, so we want to limit that,” he said. “Given the information we learned last year, I couldn’t do nothing.”

Low compares the need for regulation for teledentistry companies like SmileDirectClub to regulations in optometry. Low is the son of an optometrist and noted that optometrists want you to buy your glasses and sunglasses from their offices.

“Personally, I don’t always do that. … It’s my right. …But the prescription is made by a doctor. It’s the same thing,” he said. “I just can’t go to the mall and buy glasses without a prescription, but I went to the mall because my dad had a bad selection.”

The result of this review by Low and his team was from last october AB-1519, which provided consumer protections for teledentistry. It required that all state dentists providing orthodontics in the “correction of malpositions of human teeth or initial use of orthodontic appliances” must review a patient’s digital or conventional diagnostic x-rays before diagnosing braces or aligners or their conduct would be considered unprofessional under the Dental Practice Act. The law also states that a dental provider must not ask a patient to sign an agreement that would prevent them from filing a complaint with the dental board.

“I support innovation, I support technology, but you have to make sure you’re doing it the right way. If there’s unethical behavior, I’m going to call you,” Low said.

SmileDirectClub said it was in compliance with the law and told investors that dentists in its network were reviewing a full set of photos and an intraoral scan of a patient’s mouth, which before the pandemic were taken in person at a SmileShop. retail location. Potential patients can also take an impression of their mouth with an at-home kit and send it to the company, which then creates a dental plan and the aligners.

If an x-ray is needed, “that’s really up to the attending physician, not the state legislature,” SmileDirectClub chief executive David Katzman said during an earnings call last November, after the adoption of the new California law. “That was our opposition to the bill. But as far as compliance goes, we’re fully compliant as it stands. »

In a statement, SDC, based in Nashville, Tennessee, said it has successfully treated more than 150,000 Californians. In a state where 50% of dentists and orthodontists are located in just five of the state’s 58 counties, remote treatment for some patients may be the only viable option, especially during the pandemic.

Now Low is gaining support for another bill. The latest legislation was passed by the state Assembly in early June and was referred to a Senate committee last week. This bill, AB-1998, introduced to the pre-COVID-19 world in January, was intended to require California dentists to perform an in-person examination of their patients before approving a treatment plan for clear aligners or other orthodontics. SmileDirectClub has a dentist or orthodontist in their network who reviews each case remotely and checks in with patients every 90 days, guiding treatment remotely from start to finish.

But after objections from the California Dental Association and others, the requirement for in-person exams — a huge problem during the pandemic — was dropped. Asked about the bill in its pre-amended form in June, SmileDirectClub said it would “restrict consumer accessibility to quality, affordable care for millions of Californians.” The company also said the bill “defies logic as well as public health and safety” as telemedicine has become more necessary in the current pandemic.

The amended bill states that a patient can obtain information on how to reach their dentist after receiving the treatment plan (a complaint often heard by teledentistry patients), gives explicit rights on obtaining records signed by the patient and extends the prohibition on any patient or employee entering into a contract limiting the ability to complain to a regulatory body.

Affordable care for all is the mantra for telemedicine companies, but Low said as chairman of the state legislative committee that oversees consumer affairs, he wants to make sure consumers don’t receive care. below the average for these companies.

“It will disproportionately harm communities of color; not everyone can see health care providers,” Low said. “But the reality is that substandard treatment can do real damage, the risk is too high.”

In a statement, SmileDirectClub said “Assemblyman Low’s campaign relies heavily on donations from the California Dental Association and he has a history of protecting the dental industry’s financial interests at the expense of his constituents.”

Since 2014, Low has received $46,600 in contributions from the California Dental Association, including $1,000 from the Dental Access Plan, out of a total of $4.6 million in contributions, according to, which uses data from the nonprofit National Institute on Money in Politics. .

“Assembler Low doesn’t let contributions influence his policy decisions,” Low’s chief of staff Gina Frisby said in an email. “The company has hundreds of consumer complaints against it and as chairman of B&P, the Assemblyman is only interested in consumer protection.”

Low is chairman of the Assembly’s Committee on Business and Professions and co-founder of the California Legislative Technology and Innovation Caucus, and declined to identify donors to that group., according to a CalMatters report. After this report in February, the Law Enforcement Division of the Fair Political Practices Commission told Low he was investigating potential breaches of the disclosures, but at that time he had not made any decisions about possible violations. The investigation is still ongoing, a commission spokesperson said in an email.

Low said SmileDirectClub’s attitude is typical of many startup or unicorn IPO companies in Silicon Valley, including Uber Technologies Inc. UBER,
and Lyft Inc. LYFT,
who have a contradictory approach to regulation.

“By definition, startups move so fast, they invest in R&D, sales and marketing, and they think about regulation later,” he said, adding that he tries to make his friends think more. from the venture capital world and beyond. engage with government early on. “I was born and raised in Silicon Valley, these are candid conversations I have with my dear friends.”

After growing up in the Valley and serving as the youngest mayor in Campbell’s town history, Low has a lot of friends in the tech industry, so he’s in a tough spot at times.

“I didn’t run for the California state legislature because I wanted to take on the corporations. It gives me no pleasure to do so. I’m the chair of the technology caucus, which includes VCs from Silicon Valley. These are my people. [But] we must hold our friends to account.


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