Bill > SB386

This bill addresses payment methods for dental providers by requiring health care service plans and health insurers to establish a non-fee-based default payment method for dental providers starting April 1, 2026. The legislation mandates that before implementing a fee-based payment method, plans or insurers must obtain the dental provider's "affirmative consent" - a clearly defined term requiring an explicit, signed authorization that cannot be implied by simply accessing funds. Providers must be informed about fees, alternative payment methods, and their right to opt out at any time. The bill covers all products and services under a provider's contract, ensuring the payment method applies to their entire practice. If a provider chooses a fee-based payment method, they can switch back to a non-fee-based method at any time through written consent. The bill does not apply to direct contracts where providers can already choose their payment method. Importantly, the legislation aims to protect dental providers from being automatically enrolled in fee-based payment systems without their explicit, informed agreement, with clear provisions for transparency and provider choice in how they receive reimbursements.

Budget and Finance, Health and Social Services

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