What's happening
This bill prohibits dental insurance contracts from requiring dentists to discount fees for services not covered by a patient's plan.
Why it matters
Protects dentists’ autonomy in setting prices for procedures not covered by insurance. , which could allow dental providers to maintain fair compensation for services that insurance plans decline to pay for.
Limits insurance companies’ influence over out-of-pocket costs for patients. by preventing insurers from dictating or capping fees for non-covered dental services, potentially leading to more transparent pricing structures.
Clarifies the definition of "covered services". to ensure only those procedures for which a reimbursement is available (or would be but for plan limitations) can have insurer-mandated pricing, potentially reducing confusion for both patients and providers about what services are subject to insurer fee controls.
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Who cares
Headline styles
Ban Dental Price Controls
Plain English, a few words. Used as the page title.
Sponsors
No co-sponsors yet.
History
- Referred to insurance
- Referred to insurance
Full text
1 pageUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
2811
2019-2020 Regular Sessions
IN ASSEMBLY
January 25, 2019
Introduced by M. of A. CYMBROWITZ -- read once and referred to the Committee on Insurance
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, 2020, and shall apply to all insurance and managed care contracts issued or entered into on or after January 1, 2020.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD07412-01-9
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.