Bill > H7722

This bill clarifies how dental insurance benefits are paid directly to dental providers, regardless of whether the provider has a contract with the insurance entity. It mandates that if a patient directs their benefits to be paid to a dental provider, the insurance entity must comply and pay the benefits and compensation directly to that provider. The amount paid must be at least as much as the highest reimbursement rate the insurance entity pays to any of its contracted providers for the same service, and the entity cannot use methods like tiered pricing or network status to reduce this payment. The bill also specifies that the insurance entity can review the provider's records for the specific patient to confirm the service was rendered and meets the plan's criteria, and this change will take effect on January 1, 2027.

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