What's happening
This bill prohibits dental insurers from setting or approving fees for non-covered dental services in provider contracts.
Why it matters
Protects dentists' autonomy over pricing. By stopping insurers from dictating fees for dental services they don’t cover, the bill allows dentists to set their own rates for those uncovered services, potentially leading to more accurate pricing that reflects actual costs.
Limits insurer influence over patient costs. Patients may gain more transparency about what they’re paying for non-covered dental services, since insurers can no longer artificially cap prices for care they aren’t paying for.
Could affect out-of-pocket costs and network participation. Some patients might see higher costs for non-covered services, but dentists may be more willing to participate in insurance networks when not restricted by insurer-set fees for services not covered by plans.
Clarifies what counts as a ‘covered service’. The bill spells out that services are only considered “covered” if reimbursement is available—even if contract limitations (like deductibles or maximums) mean the insurer pays nothing—ensuring fee limitations only apply where appropriate.
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Who cares
Headline styles
Protect Uninsured Dental Discounts
Plain English, a few words. Used as the page title.
Sponsors
No co-sponsors yet.
History
- Substituted by S6496A
- Ordered to third reading rules cal.623
- Rules report cal.623
- Reported
- Reported referred to rules
- Reported referred to codes
- Print number 8141a
- Amend and recommit to insurance
- Referred to insurance
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Protect Dental Pricing Freedom
Vetoed · Sponsor Thomas F. O'Mara
Full text
1 pageUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
8141--A
2017-2018 Regular Sessions
IN ASSEMBLY
May 31, 2017
Introduced by M. of A. CYMBROWITZ -- read once and referred to the Committee on Insurance -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee
AN ACT to amend the insurance law, in relation to discounting uninsured dental services
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Section 4224 of the insurance law is amended by adding a new subsection (g) to read as follows:
(g) Notwithstanding any other provision of this section, no insurer or managed care entity authorized to do business in this state shall include any provision in any of its contracts with a dentist which requires that a dentist provide services to a covered person at a fee set by, or at a fee subject to the approval of, the insurer or managed care entity unless the dental services are a covered service under the person's dental plan. For purposes of this subsection, "covered services" shall mean dental care services for which a reimbursement is available under an enrollee's plan contract, or for which a reimbursement would be available but for the application of contractual limitations such as deductibles, copayments, coinsurance, waiting periods, annual or lifetime maximums, frequency limitations, alternative benefit payments, or any other limitation.
§ 2. This act shall take effect on January 1, 2018, and shall apply to all insurance and managed care contracts issued or entered into on or after January 1, 2018.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD11930-02-7
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.