• ​​Assignment of Benefits (AOB) is an agreement between patient and dentist specifying that the insurance company will pay the dentist directly without the patient having to pay for treatment up-front and entirely out of pocket.

• Not all insurance companies will recognize the AOB agreement between the patient and his or her dentist. By changing their policies to only pay the patient and not the dentist (provider), insurance companies force patients to pay for their entire care up-front. This practice makes many procedures unaffordable and drives a wedge between the patient and dentist.

• ​In many cases, insurance companies will only pay benefits to a provider if they sign a contract to go “in-network” with an insurance company and agree to slash their reimbursement by up to 40 or 50% of the usual and customary rates of payment for a given procedure. While many patients search for the lowest cost dental care possible, many patients would like to choose the best dentist they can find including dental specialists that are highly trained and use the most up-to- date technology. All patients should have this choice, not only those from high-income brackets.

• ​Legislation protecting the AOB agreements between patients and dentists from manipulation by insurance companies would serve as a way to level the playing field between patients, independent practitioners, and massive insurance companies.

Legislative Status

Sponsored by Representative Alice Peisch and Senator Patrick O’Connor, H.1082 and S.628 are now before the Joint Committee on Financial Services. A public hearing was held on October 29, 2019.

Background

• The Massachusetts Dentists Alliance for Quality Care (MDA) was formed in 2017 by a group of local dentists. The group has grown to over 200 independent practitioners and continues to gain support.

• ​The MDA was created in response to the aggressive changes proposed by dental insurance companies. Specifically, our concerns center around how the proposed changes will affect our patients’ ability to obtain high quality dental care in a straightforward and fair manner.

• ​As reimbursements decline for dental care in our state, dental insurance companies are trying to control prices while increasing their own profits. The playing field is not level for patients and their dentists.

• ​Without checks and balances, dental insurance companies will fundamentally change the way dental care is practiced and financed in the U.S. The MDA is extremely concerned about how these changes would affect the patients that we serve.
• ​The goal of the MDA is to protect high quality dentistry in MA. Choice, affordability, and innovation are critical components for a well-balanced dental care system in our state.

For further information, please contact Shawn Duhamel (617-899-2503) or Chris Keohan (617- 892-2765) at CK Strategies