Assignment of Benefits Legislation Takes Effect July 1

On Monday, March 11, Governor Eric Holcomb signed one of the most important dental legislative initiatives in recent history.

SEA 132 addresses a number of healthcare issues, including IDA-supported language that would require insurance companies to honor patients’ request that benefits be assigned to the dental office that provides care. While once the assumed payment method, in recent years some carriers used Assignment of Benefits (AOB) as leverage to pressure dentists into joining their provider networks.

“The decision to join or not join a network should be based on each dental office’s individual circumstances and business plan,” said IDA Executive Director Doug Bush. “Our contention was that it was unfair and inappropriate to push dentists into networks that might not be in their best interest by creating a payment hardship for the patient and a collection problem for the dentist.”

The bill also requires insurance companies to notify the dentist before selling or leasing their network to another insurance company.

“A dentist could choose to join one network and later find that that network had been leased to multiple other insurance companies,” said Bush. “Instead of making a calculated decision to join one plan, the dentist could later learn that now they were a member of multiple networks. The new law requires insurance companies to notify dentists before selling or leasing their networks to other insurance companies. Dentists will be allowed the option of opting out the networks, if they so choose.”

According to IDA Director of Governmental Affairs Shane Springer, passage of these important initiatives would not have been possible without the involvement of many IDA members.

“I had multiple legislators tell me, ‘My dentist called me… you’ve got my vote!’ That’s why the grassroots involvement of IDA member dentists is so important.”

Springer extended special appreciation to Dr. Megan Keck, Dr. DeLayne LeFevre, Dr. Paul Fisher and Dr. Mark Stetzel, who took the time to travel to the Statehouse to testify in support of the bill during committee hearings.

The insurance industry attempted to amend the bill in committee to remove the IDA supported language. “The vote was incredibly close,” said Springer. “They needed a majority vote to remove our language. Their amendments twice failed by a split vote of 6-6. I have no doubt that the testimony from our member dentists made the difference.”

Mr. Springer also commended Sen. Liz Brown, Rep. Denny Zent, Rep. Brad Barrett, and Rep. Rita Fleming, all of whom spoke forcefully in favor of the IDA-supported measures. The bill passed unanimously in the Senate and 93-1 in the House.

“Going into this year’s legislative session, we knew it would be an uphill battle taking on the insurance companies,” said Dr. Steve Holm, chair of the IDA Government Affairs Committee. “Ultimately, we were successful. This success was due largely in part to the hard work of Government Affairs Committee and our members. Whether it was testifying in committee, attending a legislative forum, or personally contacting your legislator, all of membership stepped up to get this done.”

The new law will go into effect on July 1, 2024. If may not affect all patients, as self-insured plans have generally been viewed as regulated by federal ERISA regulations, not state law. However, the ADA is monitoring a recent Supreme Court decision that may challenge that long prevailing exemption assumption.

If you have insurance companies ignore these laws after July 1, you are encouraged to contact Mr. Springer at shane@indental.org so that this information can be forwarded to the ADA for further study.