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National Council of Insurance Legislators approves model legislation to improve transparency in dental benefits

December 15, 2020

By Jennifer Garvin

The ADA received a huge boost in its mission to reform dental insurance practices for patients and the dentists who serve them when the National Council of Insurance Legislators adopted the Transparency in Dental Benefits Contracting model legislation.
Photo of Joe Ann Hart and Chad Olson
Victory: Joe Ann Hart, chief legislative officer, Florida Dental Association, and Chad Olson, director, ADA state government affairs, at an NCOIL committee meeting.

The National Council of Insurance Legislators is an organization of state legislators whose main area of public policy concern is insurance legislation and regulation. Representatives George Keiser, R-N.D., and Deborah Ferguson, D-Ark., co-sponsored the bipartisan dental benefits model that can be used as a template for introducing similar legislation around the country.

The model legislation, which was approved by the council’s Health Insurance and Long-Term Care Issues Committee on December 10, addresses three critical reform issues trending in state legislatures nationwide:

• Freedom in network leasing.
• Prior authorization.
• Virtual credit card payments.

“The model language on these three issues offers a balanced approach, empowering all three stakeholders in the dental transaction – patients, dentists and insurance carriers – in a way that supports access to care and needed clarity in how dental benefits are paid,” according to a letter the ADA and other dental groups sent the National Council of Insurance Legislators ahead of its Dec. 10 meeting.

“Passage of this model is huge," said Dr. David White, chair, ADA Council on Government Affairs. "It’s going to be so critical as we pursue legislation like this in states around the country.”

Dr. White also noted that a little over a decade ago the National Council of Insurance Legislators adopted a model law on non-covered services for dental plans, and as of today over 40 states have a non-covered services law enacted, with many of these adhering closely to the organization’s legislative language.

The ADA is continually monitoring, lobbying and providing education on behalf of dentists and the patients they serve. More than 20 new laws were enacted in 12 states in 2020 that impacted dental insurance coverage and administration.

For more information about the ADA’s advocacy efforts for fair dental insurance, visit the ADA’s Advocating for Fair Dental Insurance website.