California Gov. Gavin Newsom has signed a California Dental Association (CDA)-sponsored bill into law that will require plans to disclose whether they are state or federally regulated. The law is designed to help dental offices and patients understand the details of their dental plan coverage and whom to contact if a conflict occurs.
Assemblymember Dr. Jim Wood (D-Healdsburg), wrote the bill, AB 952. It addresses a concern long expressed by CDA members regarding a "lack of clarity on the type of dental benefit plan they are dealing with until the billing process has been completed and the plan has denied coverage or cited a billing exemption for services already rendered," the CDA said in an August 3 statement. Plans may or may not be subject to the Employee Retirement Income Security Act of 1974.
Starting in January 2025, the new law will require plans to do the following, the CDA said:
- Disclose through their online patient portal whether the patient's plan is state regulated
- Disclose upon the dental office’s request whether the patient’s plan is state regulated. This requirement is especially relevant for plans that do not have a patient portal
- Include the phrase "state regulated" on the patient’s electronic or physical insurance identification card -- or both, if they exist
"The improved disclosure will also be particularly helpful when a conflict occurs with a plan, making it easier for patients and dentists to identify which regulatory entity to contact," the CDA said.
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