The proposed bill, titled "An Act ensuring transparency in the practice of dental leased networks," introduces a new chapter, Chapter 176Z, to the General Laws. This chapter defines key terms such as "Provider Network Entity," "Third-party Health Plan," and "Participating Dental Provider," establishing a framework for transparency in the contractual relationships between these entities. It mandates that Provider Network Entities must have signed agreements with Participating Dental Providers and provide them with detailed information about the Third-party Health Plans that utilize their services. Additionally, the bill requires Third-party Health Plans to reimburse Participating Dental Providers according to specified fee schedules and to notify them of any changes in their agreements.
Furthermore, the bill outlines notification requirements for Third-party Health Plans regarding their use of Provider Network Entities and mandates annual reporting on the number of subscribers receiving dental services. It also stipulates that the Commissioner of Insurance must approve any arrangements involving Third-party Health Plans accessing Dental Networks, ensuring that such arrangements are reasonable in relation to fee schedules and premiums. Overall, the bill aims to enhance transparency and accountability in dental network practices, benefiting both providers and consumers.