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IDA introduces Fair Dental Care Act
The Indiana General Assembly held its Organization Day Nov. 22, 2011. Among key discussions were the House and Senate Republicans’ vow to work toward the passage of a “right to work” law, as well as the trend of state revenues continuing to outpace forecasts. Newly elected legislators face new districts for the 2012 election, setting the stage for a session that will likely be long on partisanship and short on meaningful debate.
The short legislative session traditionally is reserved for policies and bills that are of an urgent nature; however, this won’t stop the General Assembly from working on issues that impact organized dentisty. It’s crucial that dentists make their voices heard. The IDA will be in the Statehouse monitoring any discussion that potentially impacts Indiana dentists and patients. Further, the Association will be proactive in advocating for issues approved by IDA leadership. At the time of this writing, it is expected that Sen. Vaneta Becker (R-Evansville) will author our top piece of legislation for 2012, the Fair Dental Care Act.
For that past several years, the IDA has strongly supported Assignment of Benefits (AOB) legislation that would require insurers to honor patients’ requests that insurers pay benefits directly to the dentist who provides their care. The AOB concept garnered support from more than 60,000 patient petition signatures, as well as numerous endorsements from independent newspaper editorial boards. The AOB initiative was vigorously opposed, however, by the State Chamber of Commerce, insurance companies and some labor unions, all claiming that passage would weaken provider networks and drive up insurance costs.
This year the IDA is taking a new approach. Due to concern about the AOB legislation’s affect on health insurance premiums, the Association will be supporting a “dental only” bill that will address dental assignment concerns without impacting other health care providers. The bill will address other insurance abuses that limit patients’ ability to receive all of the insurance claim payments to which they are entitled, and drive up administrative costs for dental offices. The new IDA-supported bill will be known as the Fair Dental Care Act.
The Fair Dental Care Act
The Fair Dental Care Act will address the follow dental claims issues:
Assignment of Benefits (AOB) – Dental insurance companies will be required to honor dental patient requests regarding assigning benefits directly to the dentist who provides care.
Coordination of Benefits (COB) – When a patient is covered by more than one dental insurance policy, insurance companies will be required to coordinate benefits and pay the patient all of the benefits to which they are entitled.
Non-Covered Services – Dental PPOs (preferred provider organizations) will be prohibited from setting fees for dental procedures that are not covered by their policy.
The focus of the bill is fairness. Dental patients should receive all of the benefits to which they are entitled and should be allowed to assign benefits to their dentist in the manner that best meets their needs. Insurance companies should not be allowed to unfairly deny claims payments, or dictate the cost of procedures that they choose not to cover in their policy.
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