Bill > S808

This bill introduces comprehensive consumer protections for dental insurance policies and employee benefit plans. The legislation requires insurance providers to disclose detailed information about dental care service coverage and reimbursement, including specifying exact payment amounts or explaining the standards used to determine reimbursement (such as "usual and customary" fees). Insurance companies must create an accessible, free-to-use website that provides clear information about dental service coverage and payment rates for both patients and dentists. The bill mandates that non-contracted dentists receive payment equal to or greater than in-network dentists, allows patients to assign payment rights directly to their dentist, and ensures payment methods that don't require additional fees. Furthermore, the bill prevents insurance providers from interfering with patient dentist choices, denying dentist participation in networks, regulating medical treatment, or requiring unnecessary diagnostic procedures. It also prohibits insurers from arbitrarily reducing payments across different claims and ensures that if a pre-treatment benefit estimate is provided, the final reimbursement cannot be lower than the originally estimated amount. These provisions aim to increase transparency, fairness, and patient choice in dental insurance coverage.

Business and Industry, Health and Social Services

https://malegislature.gov/Bills/194/S808