Bill > S696

This bill establishes a new regulatory framework for dental leased networks in Massachusetts, focusing on transparency and fairness in how dental provider networks are used by health plans. The legislation defines key terms like "Provider Network Entity" (organizations that contract with dental providers or sell network access) and "Third-party Health Plan" (entities that contract to use these networks). The bill requires that when a health plan uses a leased dental network, they must provide clear documentation to participating dental providers, including a list of which health plans will use the network, specific fee schedules, and credentialing practices. Health plans must also notify their customers annually that they are using a leased network, including details about the number of patients served through each network. Importantly, the bill mandates that any such network arrangement must be approved by the Commissioner of Insurance, who will evaluate whether the network's reimbursement rates and premium charges are reasonable and not discriminatory. The goal is to increase transparency, ensure fair compensation for dental providers, and give patients more information about their dental insurance network arrangements.

Business and Industry, Health and Social Services

https://malegislature.gov/Bills/194/S696