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Minutes for HB2386 - Committee on Health and Human Services

Short Title

Establishing requirements for the payment and reimbursement of dental services by a dental benefit plan.

Minutes Content for Mon, Feb 14, 2022

Kevin Robertson, Executive Director, Kansas Dental Association (KDA), provided testimony in support of HB2386 (Attachment 1). The bill was introduced in 2021 using a template form the National Council of Insurance Legislators (NCOIL) that was a compromise on many issues between the National Association of Dental Plans (NADP) and the American Dental Association (ADA). This dealt with three issues: network leasing in section 2, prior authorization in section 3, and virtual credit cards in section 4. Through an agreement with Delta Dental of Kansas, the KDA has agreed to ask the committee to remove section 3 should the committee work the bill. Regarding network leasing, some dental carriers will lease their existing provider network to another third party entity without the knowledge of the providers. This creates problems for dentists and patients alike in regards to insurance coverage and benefits that the dentists did not know they are obligated to. HB2386 provides transparency by allowing the dentist to opt out of such requirements while staying within the original network or by allowing the dentist to not participate in third party access. Regarding virtual credits cards, some insurance carriers require dentists to accept claim payments via virtual credit card. This is accomplished by the dentist faxing in its claim and the carrier faxes back a page with the credit card number that they redeem to get paid. The issue is that the dentist is sometimes stuck with a credit card processing fee that can approach 5%. This has a significant impact on the majority of dentists that are small businesses. An example was provided. HB2386 states that that virtual credit cards can not be the only form available for payments. The bill specifies transparency to allow the dentist to make an informed decision.

Mr. Robertson responded to questions from the committee.

Dr. Allen Reavis, Immediate Past President of the Kansas Dental Association, provided testimony in support of HB2386 (Attachment 2). Network leasing is a serious concern regarding patient fairness and transparency. Often times, the dentist and the patient can not determine benefits or discounts. The dentist never has the option to review or consent to the new network. It is unfair to patients who cannot get answers from a 'faceless' insurance company. Correcting this should not cost anyone but will bring fairness and transparency. Regarding virtual credit cards, Dr. Reavis noted that in the last 37 years he has watched the insurance write-offs increase from 2-3% to nearly 20% today. Margins for small businesses are getting smaller. Insurance companies first tell dentists to write off fees and then pay with a virtual credit card that can have up to a 5% fee, cutting more into the businesses profitability. This is not sustainable or fair to dental offices. Various forms of payment should be available. Dr. Reavis asked the committee to join 16 other states that have enacted this legislation.

Dr. Jill Jenkins, President of the Kansas Dental Association, provided testimony in support of HB2386 (Attachment 3).  Dr. Jenkins stated that her small business has always been centered around one thing: the patient. The items covered in the bill are more than obstacles to a successful dentist-patient relationship, they are roadblocks. Dr. Jenkins feels an obligation to treat all children regardless of their socioeconomic status or type of insurance coverage. Dental insurance companies are allowed to lease their existing provider network to a third party, without the knowledge or permission of the provider dentists. Dentists are then providers of another insurance company whose policies are unknown. After providing the time and resources to her patients, the reimbursements are less than the cost it requires to serve my patient. If she chose not to stay with insurance company, it forces the patient to look for a new company to continue getting service from my office. Regarding the issue of virtual credit cards, one may think that the convenience and quick turn around of a credit card payment is a benefit to a small business. The additional cost of up to 5% causes an unnecessary loss on the contractually agreed upon reimbursement with an insurance carrier. The practice also provides insurance companies with tens of thousands of dollars in royalty fees. HB2386 simply provides dentists an awareness of payment options for reimbursement up front and with transparency.