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Committee adopts amendment to bar insurers from stopping patients paying for denied dental services; requires upfront disclosure
Summary
The committee amended and advanced Senate Bill 23‑77 to prohibit preferred‑provider arrangements from preventing a patient from receiving or paying for dental services their plan denied. The panel added an amendment requiring dentists to disclose to patients before care if they will charge more than the contracted in‑network rate for services not
The House Industry, Business and Labor Committee on Thursday amended and approved a measure intended to prevent insurance providers from using preferred‑provider agreements to block patients from obtaining or paying for dental services that a plan refuses to cover.
What the amendment does The committee adopted language that prohibits a preferred‑provider arrangement from restricting a covered person from receiving or paying for additional dental care services that were denied by the covered person27s dental plan. The committee then approved a further amendment requiring that if a dentist intends to charge more than the contracted provider rate for services denied by the insurer, the dentist must disclose that fact to the patient prior to beginning care.
Sponsor explanation and intent Representative Koppelman, who led work on the amendment, said the measure is aimed at preserving patient access to care when a carrier denies coverage or a patient exceeds plan limits. "We don't want an insurer to be able to stop a dentist from providing care or force a patient to forgo care," Koppelman said. The initial Senate language had been broader, and committee members said the amendment clarified scope and preserved continuity of care.
Support and concerns Several committee members and practitioners expressed concern about subsection 4, which would have required dentists to accept their contracted rate for uncovered services. Representative Ruby proposed — and members adopted — an amendment that instead requires transparent, written disclosure to the patient before care begins if the dentist intends to charge more than the insurer's contracted in‑network rate for the denied service.
Vote and carry The committee approved the amended bill on a roll call vote and Representative Ruby volunteered to carry the measure to the House floor.
Ending Supporters said the change protects patients who want to pay out of pocket for services a plan denies and preserves dentists27 ability to set fees when they disclose those fees in advance. The committee left open the possibility of further technical edits before floor action.
