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Several bills seeking to establish requirements that dental plans publicly report loss ratios have been introduced, or are pending introduction, this legislative session.
Following the adoption of the Transparency in Dental Benefits Contracting Model Act (“Model Act”) by the National Council of Insurance Legislators (NCOIL) in December 2020, NADP has seen the introduction of numerous dental network leasing bills in the states (Texas, Idaho, Utah, Kansas, South Dakota, etc).
HB 5160 was introduced in Rhode Island at the end of January. The bill model would modify the state’s existing non-covered services (NCS) law by changing the definition of covered services to include only those services that are actually reimbursed, as opposed to those that are reimbursable.
On Thursday, March 25, Dr. Vivek Murthy was sworn in as the 21st Surgeon General of the United States. Dr. Murthy previously served as the 19th Surgeon General from 2014 to 2017.
North Dakota HB 1154 was signed into law on March 25. The law, which addresses network leasing, prior authorizations and overpayment recovery was significantly modified during negotiations by lead by NADP and its industry partners.
NADP secured several favorable changes to Texas HB 1934, a network leasing and overpayment recovery bill. In addition to ensuring that carriers would be able to provide notices to providers electronically, language pertaining to leasing opt-out and notification requirements during the contract renewal process was removed.
On Jan. 14, the Centers for Medicare and Medicaid Services (CMS) finalized the “Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2022; Updates to State Innovation Waiver (Section 1332 Waiver) Implementing Regulations” (CMS-9914-F).
On Jan. 8, the U.S. Department of Health and Human Services (HHS) finalized the rule “Securing Updated and Necessary Statutory Evaluations Timely” (SUNSET), which sets a 10-year review deadline for regulations created by HHS and its agencies. The rule would also require any regulation older than 10 years be reviewed within 5 years of the enactment of the final rule, an extension from the original proposed deadline of 2 years.
In a tweet on Jan. 7 the Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma announced that the proposed Medicaid Fiscal Accountability Rule (MFAR) would be removed from the Federal Register and not finalized. NADP commented in opposition to the rule, focusing on the potential expansion of the definition of “permissible class” of healthcare for the purposes of Medicaid related taxes to include dental benefits plans.
The 2021 state legislative session is in full swing in the majority of states; numerous bills impacting dental have already been introduced. The following are a few examples of the more than 60 bills on NADP’s radar screen.