News
The Government
Relations Workgroup (GRW) continues its work of tracking and analyzing
state legislative and regulatory activities pertaining to the dental
benefits industry. Below are several recent updates:
California – Due to a legislative proposal
by the California Dental Association (CDA), which has not been
introduced, NADP is working in collaboration with the California
Association of Dental Plans (CADP) to gather a full picture of the
rebound of dental offices across the US. Please participate in the NADP Benefit Utilization Survey to support NADP and CADP lobbying efforts.
Maryland – The Attorney General’s office issued a press release informing
consumers that dentists may be violating the state Consumer Protection
Act by collecting surcharges for personal protective equipment (PPE).
The Attorney General’s office has informed the state dental community
that these activities may violate the state’s prohibition against unfair
and deceptive trade practices.
Ohio – A bill has been introduced
to require a plan that provides coverage for dental services to
reimburse dentists for PPE. The bill language is broad and does not
specify dollar amounts for reimbursement.
Pennsylvania – The Department of Insurance (DOI) has issued a notice
to insurers highlighting inappropriate billing practices related to PPE
by some dental offices. The DOI stated that some dental providers may
be charging patients outside of the insurer-provider contract. According
to the DOI, this practice could violate such contracts, and insurers
are encouraged to review their provider contracts and take appropriate
action to address the issue. In situations where the provider doing this
type of billing is not in the carrier’s network the carrier can
consider referring the matter to the Attorney General’s office.
Puerto Rico – The DOI has issued a regulatory letter requiring
insurers to include code D1999 in dental coverage commercial health
plans. The letter further states that insurers must establish a
corresponding fee for this code in an amount not less than $35 per
visit.
With questions please contact Associate Director of Government Relations Artur Bagyants.
