Illinois legislators have introduced a new bill that would require dental insurance plans to list in the fee schedule attached to the contract every Code on Dental Procedures and Nomenclature (CDT) code upon which the plan imposes a capped fee and the dollar amount of the capped fee.
SB 1545 would also require that any CDT code not so listed would not be subject to any fee cap, and the provider may balance bill the patient.
"Dental insurance plans must highlight any changes in subsequent contract terms or conditions and shall have the original plan administrator notify the enrolled dentist and allow the dentist sufficient time to respond," the proposed bill states.
In 2010, at least a dozen states enacted legislation aimed at blocking insurance providers from setting fee caps for dental procedures they do not cover: South Dakota, Virginia, Washington, Oklahoma, Oregon, Mississippi, Nebraska, Kansas, Idaho, Iowa, Alaska, and Arizona. Rhode Island already had such a law in place.
In related news, another proposed bill -- SB 1602 -- is intended to establish rules for the regulation and registration of mobile dental vans or portable dental units that provide restorative, screening, or preventative care to patients in schools and other settings in Illinois.
