Next Steps on Dental Benefits Reform Legislation
During the 2025 legislative session, WSDA successfully passed Senate Bill 5351, which made meaningful progress on several important dental benefits reform issues.
Two of the changes resulting from WSDA’s dental benefits reform bill are effective as of July 27, 2025:
- Same-Day Denials: Prohibits same-day denials for multiple procedures just because they were performed during a single appointment when they would otherwise be covered.
Virtual Credit Cards: Restricts insurance companies from requiring dental offices to accept payment through virtual credit cards that carry processing fees.
Learn more about these new restrictions here.
It’s especially important that we hear of any instances where dental offices discover dental benefits providers appear to be failing to comply with these new legal requirements. If you notice this in your office, please email dentalbenefits@wsda.org.
Next Steps on DLR & Non-Network Reimbursement
In addition to the changes above, our bill also established a mediation process for identifying the changes needed on two of Washington’s most pressing dental benefit issues:
- Non-Network Reimbursement Fairness: Equity in the benefit reimbursements for out-of-network care.
- Dental Loss Ratio (DLR): Establishment of a minimum percentage of premiums that any carrier must pay out in the form of dental patient claims.
The mediation process, which began in late August, is being conducted by the William D. Ruckelshaus Center, a non-partisan dispute resolution program managed jointly by the University of Washington and Washington State University. It will include representatives from WSDA, DDWA and other stakeholder groups. WSDA believes that we have a compelling case on both issues, and we are committed to investing the resources necessary to gather and present relevant data to support our positions.
We expect the resulting recommendations by the Ruckelshaus Center to be presented to the Legislature for consideration during the 2027 legislative session. While we had hoped that mediation on at least one of the issues could have been completed in time for the 2026 legislative session, the deadline in the bill points to 2027, and we believe that our case to lawmakers — and our chances for a successful resolution — will be enhanced by a thorough review.
2026 Dental Benefits Legislation Preview
WSDA will continue to propose additional dental benefits reforms to enhance dentists’ ability to care for their patients.
In 2026, we intend to introduce legislation that would prohibit the arbitrary age limit on fluoride varnishes imposed by some dental plans. These limitations are not medically supported, and as more communities across the state consider suspending fluoride treatment of their water supplies, it is likely to become a greater problem for adult patients.
