On Sept. 22, ODA Past President Dr. Sharon Parsons and I testified before the Ohio House of Representatives Insurance Committee in support of House Bill 344, which would prohibit dental insurers from setting fees for dental services that the insurance companies do not even cover.

I pointed out that “this practice of insurance companies dictating fees for services they don’t even cover is creating significant hardships for dental offices and interferes in the dentist-patient relationship.” I explained that “this tactic by the insurance companies often acts to limit patient choices, forcing some patients to forgo preferred treatment options or disrupting continuity of care by forcing patients to go to other dentists for certain procedures.”

Dr. Parsons provided her real world experience related to the non-covered services issue. She testified most non-covered services are elective or cosmetic procedures that the patient chooses to have, but are not considered essential by the insurance company, and thus are not covered.

She explained:

“Most of these cosmetic procedures are very costly to perform because they take a lot of time, and many involve lab fees. If I am reimbursed at a level less than my costs, I am forced to cut corners or use a lesser quality lab in order to make ends meet. That in itself changes the relationship I have with my patients. I have spent my career giving my patients my best work. How can I now give them something less?”

Parsons also testified that she has heard from the insurance industry that these non-covered service policies are “for the good of the patients.” She refuted that argument by pointing out that:

“If this continues to be allowed, I will be forced to drop the insurance of over 500 families. They will have to pay more money out of pocket to continue their care with me or change to an office that does not know them and will be bound by these same restraints. How is this better for the patient?”

Several members of the Insurance Committee asked questions trying to gain an understanding of the dental insurance marketplace and the burdens that these non-covered services tactics being employed by the insurers are causing for dental practices and their patients.

We expect additional hearings on House Bill 344 to be held throughout the fall. Keep your eye on the “ODA Today” and ODA’s electronic publications for regular updates on this important legislation.