HB 1316: Expand Patient Bill of Rights
WSDA supports ensuring that dental patients have the same protections when accessing dental care as when accessing medical care. We also support eliminating the unfair insurance practices of some dental insurance carriers. That’s why we support HB 1316, sponsored by Representative Michelle Caldier.
The patient bill of rights does not currently include coverage provided by stand-alone dental plans. HB 1316 would expand the patient bill of rights to cover stand-alone dental insurance carriers, holding dental benefit carriers more accountable to their clients.
HB 1316 would also give dental patients the same protections as medical patients:
- Requirement for carriers to have a comprehensive, independent grievance and appeal process
- Requirement for an independent review organization to hear disputes related to decisions made by carriers
- Requirement for carriers to have written utilization review criteria based on reasonable medical evidence
The bill would also prohibit dental insurance carriers from taking punitive action against a provider when disputing a carrier’s decision on coverage or payment for dental service on behalf of a patient, and from advertising coverage for dental services for which the carrier denies coverage.
Reports from the Office of the Insurance Commissioner indicate that the number of patient and provider complaints regarding dental benefit companies is increasing significantly, and Insurance Commissioner Mike Kreidler recently authored an op-ed in the WSDA News about the importance of filing complaints. The increase in complaints from both patients and providers shows that legislative action is needed.