BILL WOULD ALLOW FREE REIGN ON DENTAL PRICING

Association Opposes ‘Anti-Consumer’ Proposal

JUNE 13, 2013: A bill that would allow dentists to negate contractual agreements with insurance companies that offer discounted pricing on dental care is now pending before the Joint Committee on Financial Services. The proposal, if passed into law, would allow dentists free reign to set prices on dental services at any level they choose, once a patient exhausts their annual dental insurance benefit.

Massachusetts dentists claim that the long-standing discount provisions contained in many dental contracts amount to price fixing and result in financial hardship for dentists. Supporters of H981 and S422 also claim that such contractual provisions result in higher prices for patients who do not have dental insurance.

At issue are the fees charged to patients after the dental insurance benefit has been exhausted for the year. Most dental insurance plans offer an annual benefit of $1,250 to $2,000 a year, but then offer discounted pricing for those procedures performed after the benefit has been exhausted.

Association officials first became aware of this proposal, which is strongly opposed by dental insurance companies, such as MetLife, late in 2012. At that time the proposal was passed by the House and Senate, but vetoed by Governor Deval Patrick after the Association, state’s Group Insurance Commission and the Division of Insurance raised concerns.

With his veto, Patrick also called for the creation of a special commission to study dental care and insurance benefits. He then proposed the creation of the special commission in his FY14 budget proposal, which was also endorsed by the House. The language is now being debated by a House/Senate Budget Conference Committee.

At Wednesday’s hearing, Executive VP and General Counsel Bill Rehrey detailed the Association’s concerns over the proposal, which mirrors that vetoed by the governor late last year. Rehrey explained that the plan may harm those state and local retirees enrolled in the GIC’s Retiree Dental program due to higher out-of-pocket costs for what are now discounted services.

Earlier, MetLife, which is the GIC’s dental carrier, explained that the discount program has been in place for “many decades” and is standard practice among most dental insurance plans. According to dental insurance officials, dentists, who opt to participate in the insurance networks, agree to abide by the plan’s fee schedule. In return, dentists have increased access to patients, receive prompt payment for covered services and are offered free continuing education.

The GIC and our Association have long promoted the discount program as a benefit of joining the Retiree Dental Insurance plan. Once the retiree exhausts their annual benefit, they still are able to access affordable services due to being a member of the plan and seeing an in-network dentist.

“Since the Association played a central role working with the GIC to create the Retiree Dental Plan in the first place back in 2002, we’re particularly concerned by anything that would undermine the success of the program,” explains Rehrey. “These bills might help dentists, but they will harm retirees. If passed into law, our members’ costs will go up.

“We’ve asked that the Committee not release the proposal in its current form. Thankfully, the GIC, Division of Insurance and insurance industry representatives share our position and have opposed the bill.”

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