BILL NUMBER: S5326
SPONSOR: BAILEY
 
TITLE OF BILL:
An act to amend the insurance law, in relation to standardized health
insurance contracts for small dental employers; and providing for the
repeal of such provisions upon the expiration thereof
 
PURPOSE OR GENERAL IDEA OF BILL:
The purpose of this bill is to boost the pool of dentists providing
services to Medicaid patients by qualifying certain dental practices as
eligible to participate in the Healthy New York health insurance
program.
 
SUMMARY OF PROVISIONS:
Section 1 amends section 4326 of the insurance law to expand its appli-
cability to qualifying small dental employers, defined as a dental prac-
tice with 50 or fewer employees that employs at least two dental hygien-
ists and where every dentist in the practice provides at least ten
dental office visits per month to patients receiving medical assistance
coverage.
Section 2 amends sections 4327 of the insurance law to expand the cover-
age of stop loss funds for standardized health insurance contracts to
include coverage for qualifying small dental employers.
 
JUSTIFICATION:
Despite graduating 750 dentists annually - among the highest numbers of
any state - New York continues to struggle with unmet need, particularly
with respect to Medicaid recipients and other vulnerable populations.
Several barriers contribute to the challenges of providing access to
dental care to low-income, rural or developmentally disabled individ-
uals, including the exorbitant costs of attending dental school, the
high costs of establishing a dental practice, and perennially insuffi-
cient Medicaid reimbursement rates. This bill seeks to lower overall
dental practice expenses by offering qualified dental practices the
ability to purchase health insurance coverage for their employees and,
it desired, the families of their employees, through the Healthy New
York insurance program.
New York State currently has 156 dental Health Practitioner Shortage
Areas (HPSAs), including 92 designated HPSA facilities and 64 designated
HPSA population groups (mostly Medicaid eligible populations). This
means that each of these designations has a population-to-provider ratio
of at least 4,000 people to 1 dentist. NYS currently meets only 16.68%
of the documented need, so it is imperative that we find ways to attract
dentists and other oral health professionals to practice in these HPSAs,
including by making it financially viable to do so. Recognizing that
most dentists practice in private practice settings, this bill seeks to
make it easier for dentists to practice in a HPSA by lowering a major
driver of dental practice costs.
 
PRIOR LEGISLATIVE HISTORY:
2023-24: S8143 - Passed Senate
 
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:
None.
 
EFFECTIVE DATE:
Immediately.