Bill > SB386

This bill requires health care service plans and health insurers to establish a non-fee-based default payment method for dental providers, which means providers will not be charged a fee to access their payment. The bill mandates that before implementing a fee-based payment method, plans or insurers must obtain "affirmative consent" from the dental provider, which requires a clear, signed agreement (including electronic signatures). When a dental provider opts into a fee-based payment method, the plan or insurer must provide detailed information about fees, alternative payment methods, and the provider's right to opt out at any time. Providers can choose to opt out of fee-based payments and return to a non-fee-based method whenever they want, and this decision will apply to their entire practice and all services covered under their contract. The bill also requires plans and insurers to notify providers if their payment vendor is sharing profits or has a special fee arrangement. These provisions will become operative on April 1, 2026, and will apply to new, amended, or renewed health care service plan contracts and health insurance policies. The bill does not apply to situations where providers already have a contract allowing them to choose their payment method, and it is designed to protect dental providers from unexpected or unwanted payment fees.

Budget and Finance, Health and Social Services

https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=202520260SB386