Ohio passes bill aimed at improving dental insurance, license portability

State joins Dentist and Dental Hygienist Compact

Ohio lawmakers passed legislation that aims to improve dental insurance and license portability, with Gov. Mike DeWine signing the bill into law July 24. 

Senate Bill 40 enters Ohio into the Dentist and Dental Hygienist Compact and addresses the limitations health insurers impose on dental care services. Manish Chopra, D.M.D., Ohio Dental Association president and chair of the ODA executive committee, said the bill’s passage marks a “significant victory” for the state and would not be possible without the lobbying team and member dentists who testified on behalf of both provisions of S.B. 40. 

“The noncovered services bill will protect dentists from unfair insurance practices by prohibiting insurers from setting fees for services they do not cover, ensuring dentists can establish fair and reasonable fees for their services,” Dr. Chopra said. “[The compact] will streamline the licensure process, making it easier for dentists to move and work across state lines, ultimately improving access to dental care. This is a big win for Ohio dentists.”

Joe Crowley, D.D.S., past ODA and ADA president and chair of the Coalition for Modernization of Dental Licensure, testified before the Ohio House Health Provider Services Committee in favor of the DDH Compact provisions of S.B. 40. The DDH Compact is an interstate licensure agreement that supports license portability by permitting dental professionals to practice in multiple states without the need for separate licenses. Ohio is the tenth state to join the compact, following Colorado, Minnesota, Maine, Washington, Iowa, Tennessee, Virginia, Wisconsin and Kansas. 

Dr. Crowley shared excitement that both the ODA and the Ohio legislature saw the value of the compact and expressed hope that other legislative jurisdictions follow suit. 

“License portability for dentists and dental hygienists makes sense at so many levels. The compact becomes a frontline tool to help accommodate the portability process. In the end, the oral health community and the patients that are served by the profession win with the legislation,” Dr. Crowley said. “Continued passage throughout [the] U.S. is imperative to success. I am so pleased our Ohio legislators recognized the value by moving the DDH Compact forward.”

The bill passed 22-9, with some lawmakers opposing the noncovered services provisions. Sharon Parsons, D.D.S., past ODA president who testified multiple times throughout the years before the Ohio House and Senate insurance committees in favor of noncovered services, said the provision took a while to pass.

Noncovered services legislation was introduced several years ago after having passed in many other states, Dr. Parsons noted, but Delta Dental decided to fight it in Ohio. She testified on behalf of the bill because “it is an unfair practice levied by insurance companies,” she said.  

Dr. Parsons highlighted that dentists who sign contracts with insurance companies to be participating providers in preferred provider organizations must accept the carrier’s fee schedule for the covered services. This sometimes means dentists barely make a profit on certain procedures and, in some cases, they must limit their fee for services the insurance company deems unnecessary to cover. 

In her testimony Dr. Parsons mentioned that dentists often have to make the difficult decision of whether or not to perform a noncovered service, which as a result interferes with the dentist-patient relationship.

“If we are facing a situation where we can't afford to do a procedure that the insurance company does not cover, we may have to tell the patient that they will need to seek this treatment elsewhere, which is very difficult for them after they have built a trusting relationship with us,” Dr. Parsons said. 

Under S.B. 40, dental insurance companies will no longer be allowed to require dentists to charge a fee set by the insurer for services the insurer does not cover. If the dentist chooses to charge their regular fee for noncovered services, they must provide the patient seeking noncovered services with pricing and reimbursement information and post the following notice in a conspicuous place:

"IMPORTANT: This dental care provider does not accept the fee schedule set by your insurer for dental care services that are not covered benefits under your plan and instead charges his or her normal fee for those services. This dental care provider will provide you with an estimated cost for each noncovered service," reads the bill. 

According to Dr. Parsons, this new legislation is a very important step forward for dental professionals and the patients they treat. 

“The business of an insurance company is to accept risk. The business of a dentist is to treat patients in exchange for a fair fee. The dentist should not have to accept risk so that the insurance company can sell policies by advertising these services at lower cost, especially when the company does not deem them important enough to cover,” she said. 

For more information on dental insurance, visit this ADA webpage. For more information on the DDH Compact, visit ddhcompact.org.