OHIO LEGISLATIVE SERVICE COMMISSION
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S.B. 40 Final Analysis
135th General Assembly
Click here for S.B. 40’s Fiscal Note
Primary Sponsor: Sen. Roegner
Effective date: Sections pertaining to the Dentist and Dental Hygienist Compact effective
January 1, 2025; sections pertaining to insurance coverage of dental care services effective
October 24, 2024
Effective date:
Emma Carroll, Research Analyst Updated Version*
SUMMARY
Dentist and Dental Hygienist Compact
▪ Enters Ohio as a party to the Dentist and Dental Hygienist Compact, the purpose of which
is to facilitate the interstate practice of dentistry and dental hygiene and improve public
access to dentistry and dental hygiene services.
▪ As a member of the Compact, requires Ohio to allow a dentist or dental hygienist licensed
in another participating state to practice in Ohio, subject to Ohio’s laws and rules
governing the practice of dentistry and dental hygiene.
▪ Requires the State Dental Board to appoint a member to the Dentist and Dental Hygienist
Compact Commission, a joint public agency created by the Compact to enforce the
provisions and rules of the Compact.
▪ Requires Ohio to submit data regarding dentist and dental hygienist licensees to the
Commission’s data system, including information related to licensure, adverse action, and
the presence of significant investigative information.
▪ Requires the Board to issue a report assessing the impact of Ohio having entered into the
Compact five years after the Compact takes effect.
Insurance coverage of dental care services
▪ Requires health plan issuers to notify covered persons that they may incur out-of-pocket
expenses for dental care services that are not covered services.
* This version updates the effective date.
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▪ Prohibits a contracting entity from requiring a dental care provider to accept a payment
amount set by the contracting entity for dental care services that are not covered
services.
▪ Designates a violation of these provisions an unfair and deceptive act in the business of
insurance.
▪ Requires dental care providers to disclose pricing and certain other information for dental
care services that are not covered services.
▪ Subjects providers who violate the act’s disclosure requirements to professional
discipline.
DETAILED ANALYSIS
Dentist and Dental Hygienist Compact
Effective January 1, 2025, the act enters Ohio into the Dentist and Dental Hygienist
Compact. The Compact is an agreement between participating states that improves public access
to dentistry and dental hygiene services by permitting eligible dentistry and dental hygiene
providers to work in multiple states.1 The Compact went into effect when it was enacted by the
seventh participating state.2 Each state’s enacting statute cannot be materially different from the
Model Compact. Nothing in the Compact impacts Ohio’s requirements for a license to practice
as a dentist or dental hygienist.3
State participation in the Compact
To participate in the Compact, a state – including Ohio – must: 4
1. Enact a compact that is not materially different than the Model Compact;
2. Fully participate in the Commission’s data system (see “Compact Commission” and
“Data system,” below);
3. Have a mechanism for receiving and investigating complaints;
4. Notify the Commission of any adverse action or the availability of investigative
information about a licensee;
5. Fully implement a criminal background check requirement and use the results in making
licensing decisions in accordance with the Compact;
6. Comply with the rules of the Commission;
1 R.C. 4715.271; Section 1. (“Section” references in this analysis are to the Compact.)
2Section 11.A. As of July 19, 2024, ten states have enacted the Compact: Colorado, Iowa, Kansas, Maine,
Minnesota, Ohio, Tennessee, Virginia, Washington, and Wisconsin.
3 Section 1.E.
4 Section 3.A.
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7. Use an approved examination as a license requirement;
8. Require licensees to graduate from a program accredited by an approved accreditation
agency;
9. Require all licensees to successfully complete a clinical assessment;
10. Have continuing professional development requirements as a condition of license
renewal;
11. Pay a participation fee to the Commission as established by Commission rule.
Compact privilege
Compact privilege is authorization granted by a remote state to allow a dentist or dental
hygienist licensee from another participating state to practice as a dentist or dental hygienist in
the remote state under its laws and rules. A dentist or dental hygienist working under compact
privilege must function within the scope of practice authorized by that state.5
Each participating state must grant compact privilege to a licensee holding a valid,
unencumbered license in another participating state. Participating states may charge a fee for
granting compact privilege. The Dentist and Dental Hygienist Compact Commission (see
“Compact Commission” below) also may charge a fee for granting compact privilege. The
Commission’s fee is waived for active military members and their spouses, and states may choose
to waive fees for active military members and their spouses as well.
If a licensee’s license is encumbered, the licensee automatically loses compact privilege
in all remote states until the license is no longer encumbered. Once a restricted license is restored
to good standing, the licensee must meet all requirements to obtain compact privilege in a
remote state.
Requirements to grant privilege
To exercise the compact privilege, a licensee must:6
1. Be licensed as a dentist or dental hygienist in a participating state;
2. Have no adverse action imposed on their compact privilege in the remote state where
they will be practicing;
3. Submit to an application process in every state the licensee is seeking compact privilege;
4. Pay any applicable fees to the Dentist and Dental Hygienist Compact Commission and
the remote state;
5. Meet any jurisprudence requirement established by a remote state where the licensee
is seeking compact privilege;
5 Sections 2.G and 4.C.
6 Section 4.A.
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6. Have passed a National Board Examination of the Joint Commission on National Dental
Examinations or another examination accepted by Compact Commission rule;
7. If a dentist, have graduated with a Doctor of Dental Surgery or Doctor of Dental Medicine
degree from a predoctoral dental education program accredited by an approved
accreditation agency;
8. If a dental hygienist, have graduated from a dental hygiene education program
accredited by an approved accreditation agency;
9. Have successfully completed a clinical assessment;
10. Report to the Compact Commission any adverse action taken by a nonparticipating state;
11. Report their address to the Compact Commission and consent to accept service of
process and service of subpoena at that address.
Practicing in a remote state
The Compact requires any licensee practicing dentistry or dental hygiene in a remote
state under compact privilege to practice in accordance with the laws and regulations of the
remote state. Licensees practicing dentistry or dental hygiene in a remote state are subject to
the remote state’s regulatory authority, meaning a remote state may temporarily remove a
licensee’s compact privilege, impose fines, or take other actions that are necessary to protect the
health and safety of the state’s citizens. A licensee is ineligible for compact privilege in any state
until a remote state has reinstated the licensee’s compact privilege in the remote state.7
Adverse actions
The Compact provides that a participating state in which a licensee is licensed has the
exclusive power to impose adverse action against a license it issues. Adverse action is defined as
disciplinary action or encumbrance imposed on a license or compact privilege by a state licensing
authority.8
A participating state may take adverse action based on investigative information from a
remote state, so long as the participating state follows its own procedures. While states that are
not the participating state that issued the license cannot impose adverse action against the
license, a participating state may take adverse action against a licensee’s compact privilege in
that state. Joint investigations between participating states also are permissible.9
In addition to imposing adverse action against a licensee’s compact privilege, a remote
state may (1) issue subpoenas for hearings and investigations and (2) recover from the licensee
the costs related to the adverse action against the licensee (if authorized by state law).10
7 Sections 4.C and D.
8 Sections 6.A and 2.B.
9 Section 6.E.1 and F.
10 Section 6.E.
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The Compact preserves a state’s ability to permit a licensee to participate in an alternative
program in lieu of adverse action, but the state must require licensees who enter alternative
programs in lieu of discipline to agree not to practice in other participating states during the term
of the alternative program, unless the participating state gives prior authorization.11 “Alternative
program” is defined as a nondisciplinary monitoring or practice remediation process approved
by a state licensing authority.12
If a participating state imposes adverse action against a licensee, it must immediately
notify the administrator of the Commission’s data system (see “Data system” below).13
Impact of compact privilege removal by a remote state
If a remote state removes a licensee’s compact privilege, the licensee’s compact privilege
in any other participating state is removed until the time for which compact privilege was
removed has ended, all fines have been paid, and all other conditions imposed by the remote
state have been met. The licensee must again meet the above requirements to obtain compact
privilege.14
Compact Commission
The act requires states participating in the Compact to establish a joint public agency
known as the Dentist and Dental Hygiene Compact Commission. Each participating state must
appoint one commissioner. The commissioner is entitled to one vote regarding all matters that
are voted on by the Commission, and must participate in the business and affairs of the
Commission. Meetings may take place by telecommunication, video conference, or other similar
electronic means.15
The State Dental Board must select one commissioner to the Commission within 60 days of
Ohio entering the Compact, and must fill any subsequent vacancy within 60 days.16
Powers and duties
The Commission must enforce the provisions and rules of the Compact.17 It is required to
meet annually. Generally, meetings must be open to the public. The Compact permits closed,
nonpublic meetings of the Commission, its Executive Board, or other committees in limited
circumstances, such as to discuss noncompliance of participating states, employment matters,
11 Section 6.C.
12 Section 2.C.
13 Section 6.G.2.
14 Section 4.D, G, and H.
15 Section 7.
16 Section 7.B and R.C. 4715.272(A).
17 Section 10.J.
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licensee discipline, litigation, contract negotiation, criminal accusations, trade secrets,
investigative records, and legal advice.18
The Commission has numerous powers and duties specified in the act, some of which
include:19
1. Establishing bylaws and a code of ethics for the Commission;
2. Electing a chair, vice chair, secretary, and treasurer, and any other officer provided by
the Commission’s bylaws;
3. Maintaining financial records, establishing a budget, making expenditures, and
borrowing money;
4. Adopting rules to facilitate and coordinate implementation and administration of the
Compact, including emergency rules;
5. Hiring employees and performing matters related to personnel;
6. Accepting donations and gifts and taking actions regarding real and personal property;
7. Electing the Executive Board and appointing committees;
8. Performing other functions as necessary and appropriate to achieve the purposes of the
Compact.
Data system
The Commission must provide for the development, maintenance, and use of a
coordinated database and reporting system containing licensure, adverse action, and significant
investigative information regarding licensed individuals in participating states. All participating
states must submit a uniform data set to the data system regarding licensees that are subject to
the Compact. The data set includes: (1) identifying information, (2) licensure data, (3) adverse
actions against a licensee, license applicant, or compact privilege, (4) nonconfidential information
related to alternative program participation, (5) any denial of an application for licensure and
reasons for the denial, (6) the presence of significant investigative information, and (7) other
information specified in Commission rules.20
Participating states contributing information to the data system may designate
information that may not be shared with the public without its express permission. Investigative
information received by a dental licensing board pertaining to the investigation of a licensee in a
participating state will always only be available to other participating states.21
18 Section 7.
19 Section 7.C.
20 Section 8.
21 Section 8.E. and F.
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Commission finances
The Commission must pay the reasonable expenses of its establishment, organization,
and ongoing activities. It may accept monetary and nonmonetary donations and grants. It may
impose annual assessments on participating states and fees on licensees of participating states
to cover costs of granting compact privilege. The Commission must keep accurate records of
receipts and disbursements, which must be audited annually.
The Commission is not permitted to incur obligations before securing funds to meet those
obligations and it may not pledge the credit of participating states without authority.22
Executive Board
The Compact creates a Compact Commission Executive Board, and provides that the
Executive Board has the power to act on the Commission’s behalf. Board meetings with formal
action on a matter must be public, with at least five days’ notice. The Executive Board, which
must meet annually, is comprised of up to seven members, including: 23
 The chair, vice chair, secretary, and treasurer of the Commission, and any other officer
provided by the Commission’s bylaws;
 Up to three other voting members from the Commission, elected by the Commission.
Duties and responsibilities of the Executive Board include:24
1. Overseeing the day-to-day administration of the Compact;
2. Recommending changes to rules, bylaws, Compact legislation, and fees paid by
participating states and licensees;
3. Ensuring Compact administration services are appropriately provided;
4. Preparing and recommending the budget;
5. Maintaining financial records;
6. Monitoring Compact compliance of participating states and providing compliance
reports;
7. Establishing additional committees;
8. Exercising the Commission’s powers and duties between Commission m