A bill that would prohibit dental-only insurance plans from denying coverage for emergency dental conditions in certain situations was moved through the state House of Representatives and into the Senate Health Care Committee on Wednesday.
Sponsored by Rep. Richard DeBolt, R-Centralia, House Bill 1002 would not allow dental-only plans to deny coverage for emergency dental treatment when it would be otherwise covered on the basis that the service was provided on the same day the insured person was examined and diagnosed for the condition.
The bill defines an emergency condition as something that would place the patient in serious jeopardy, cause impairment of bodily functions or cause serious dysfunction of an organ or body part.
If approved, the bill would also require dental-only plans to report aggregate-level information on the total number of dental members, amounts of dental revenues, dental payments and dental loss ratios, average amount of monthly premiums and the percentage change in the average premium per member per month measured from the previous year to the state Office of the Insurance Commissioner.
The commissioner’s office would then make that information available online.
Supporters of the bill, including the Washington State Dental Association, Delta Dental of Washington and Willamette Dental Group, say it is a patient advocacy bill that prevents insurance carriers from denying reimbursement if care is provided on the same day.
They also say dentists are often forced to absorb the costs of the treatment as a result.
