Dental providers: fee-based payments.
Vote required
Majority
Fiscal committee
No
Appropriation
No
Current location
Chaptered
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Senate
- Passed Assembly
- To Governor
- Became Law
Overview
This bill establishes rules for how health care service plans and health insurers handle payments to dental providers. It requires these plans and insurers to have a non-fee-based default payment method and obtain affirmative consent from dental providers before offering fee-based payment options. Dental providers can opt-in or opt-out of fee-based payments at any time, and the chosen method must apply to all services covered under their contracts.
Key provisions
- Health care service plans and insurers must have a non-fee-based default payment method for dental providers.
- Affirmative consent is required from dental providers before offering fee-based payment options.
- Dental providers can opt-out of fee-based payments at any time.
- The chosen payment method must apply to all services covered under the provider’s contracts.
- Plans and insurers must provide information about fee-based payment methods to providers.
- The bill applies to contracts issued, amended, or renewed on or after April 1, 2026.
- The bill does not apply if a direct contract already allows the provider to choose payment methods.
- The bill addresses both health care service plans and health insurers.
Who is affected
- Health care service plans
- Health insurers
- Dental providers
- Patients receiving dental care
- Contracted vendors facilitating payment processing
Bill text
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Sponsors
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1 on record
Primary sponsor
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