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Committee hears bill to add dental claims to Nevada’s external-review process
Summary
Assembly Bill 202 would allow denied dental claims to be reviewed through Nevada’s external-review process currently available for medical claims; supporters said it would provide recourse for patients and require dentists’ participation in reviews while insurers warned about costs and differences from medical coverage.
Assemblymember Tracy Brown May told the Senate Committee on Commerce and Labor that Assembly Bill 202 would expand Nevada’s external-review process to cover dental claims that are currently excluded, allowing patients and dentists access to an independent review when insurers deny coverage.
Why this matters: supporters said dental claim denials currently leave patients without the same appeals pathway used for medical claims. Paul Klein, who joined the sponsor to present the bill, said the proposal adds dentists to the definition of clinical peers for external review, ensures independent review organizations include dentists in the process, and allows dentists to submit written certifications and to request expedited reviews for adverse determinations.
What supporters said
Paul Klein summarized the bill’s primary changes: adding dentists to the roster of clinical peers; expanding external-review eligibility to dental policies; permitting written certifications and expedited external review requests submitted by dentists; and requiring independent-review organizations to consider a dentist’s recommendations in the documentary record. “By adding dental to the state’s external review program we will ensure medically necessary treatments are covered by insurance, putting patients before profits,” Klein told the committee.
What opponents said
Helen Foley, representing Delta Dental, testified in opposition and warned that dental coverage differs structurally from medical insurance. Delta Dental said many dental policies carry annual caps (commonly $1,500–$2,500) and cover routine services; Foley argued that requiring external review for small-dollar disputes could be disproportionately costly and operationally burdensome. She said many disputes are resolved through existing appeals and that the frequency and dollar limits in dental benefit design make the external-review model less appropriate than it is for high-cost medical care.
Committee questions and next steps
Vice Chair Daley and other senators asked whether the Office of Consumer Health Assistance and independent-review organizations have the necessary dental subject-matter experts; Paul Klein said the office has consulted and can draw from directories of qualified reviewers. No committee vote is recorded in the hearing transcript. Assemblymember Brown May said she supports the expansion to provide patients an independent avenue for recourse when claims are denied.
Ending
The committee heard both patient-advocate and insurer perspectives. Opponents focused on cost and structural differences between dental and medical benefit design; supporters said the change would align dental beneficiaries with protections already available to medical patients. The transcript records committee discussion but no final disposition or recorded vote.
