A bill introduced under Oklahoma's House of Representatives is causing a divide among dental professionals and insurers in the state.
Five notes:
1. House bill 3023, introduced Jan. 14, redefines covered services and would prevent insurers from deciding the cost of uncovered procedures, instead authorizing those costs to be decided between patients and dentists. It would also require insurers to explain the reasoning for downcoding and bundling of procedures.
2. John Gladden, CEO of Delta Dental of Oklahoma, told ABC affiliate KSWO March 12 that insurance companies cannot legally dictate fees for uncovered services and that dentists must decide what to charge for those services. He said the bill would instead result in patients paying more.
3. Mr. Gladden also opposed the bill in a March 2 column for The Oklahoman, saying that should the bill pass, its members alone would face more than $15 million annually out-of-pocket for their dental care. About 1 million Oklahoma residents are under Delta Dental's network, according to KSWO.
4. Chris Fagan, DDS, in a March 11 column for The Oklahoman said insurer practices such as bundling and downcoding may result in some patients paying less but could lead to patients from other plans or who are uninsured paying more to compensate for the difference.
5. On Feb. 16, the House insurance committee advanced HB 3023 but directed the bill's author, Rep. Rande Worthen, to amend the bill so it does not benefit one constituency. If the bill passes the House, it would then move onto the Senate.