Bill > SB5351

This bill addresses several key provisions related to dental insurance practices in Washington state. First, the bill prohibits dental insurance plans from denying coverage for procedures solely because they were performed on the same day, while still allowing denials for legitimate reasons such as fraud prevention, clinical inappropriateness, medical necessity, or plan benefit limitations. Second, it establishes new rules for claim reimbursement, requiring dental insurance carriers to notify providers in advance about any credit card fees, offer alternative payment methods without fees, and provide clear payment instructions. The bill also mandates the creation of a collaborative forum facilitated by the William D. Ruckelshaus Center, which will bring together dental associations, insurance carriers, consumer representatives, and the insurance commissioner to discuss issues like dental loss ratios and provider payment rates. Additionally, the bill amends existing law to require dental insurance carriers to submit annual reports to the insurance commissioner with detailed financial information specific to Washington state, which will be made publicly available through a searchable website. The goal of these provisions is to increase transparency, fairness, and patient access in dental insurance practices.

Budget and Finance, Health and Social Services

https://app.leg.wa.gov/billsummary?BillNumber=5351&Year=2025&Initiative=false