Bill > H1306

This bill introduces comprehensive regulations for dental leased networks, establishing transparency and fairness in how dental provider networks are accessed and managed. The legislation defines key terms such as Provider Network Entities (organizations that contract with dental providers or lease dental networks), Third-party Health Plans (entities accessing these networks), and Participating Dental Providers. The bill requires Provider Network Entities to have signed written agreements with dental providers and disclose critical information like which health plans have access to their network, applicable fee schedules, and administrative policies. Third-party Health Plans must clearly notify customers when they are using a leased network, provide annual reports detailing network usage, and maintain consistent credentialing and quality standards across all networks. The bill mandates that provider directories clearly indicate when providers are part of a leased network, and requires that any disputes be resolved according to the original agreement between the dental provider and the network entity. Importantly, the Commissioner of Insurance must review and approve such network arrangements, ensuring they are reasonable in terms of reimbursement rates, premiums, and do not unfairly discriminate against providers or patients. This legislation aims to increase transparency, protect dental providers' interests, and provide clearer information to patients about their dental network arrangements.

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https://malegislature.gov/Bills/194/H1306