Wis. Assembly passes dental insurance change

Wis. Assembly passes bill changing dental insurance contracts despite business opposition

Associated Press

MADISON, Wis. (AP) -- Wisconsin's Republican-controlled state Assembly, over opposition from the powerful business lobby, passed a bill on a bipartisan vote Wednesday that would allow dentists to charge more for certain services by forcing changes in existing private contracts.

Wisconsin Manufacturers and Commerce, which usually works in concert with Republicans, sent a letter to lawmakers hours before the vote urging that the bill be defeated and calling it unwarranted government intrusion on business. The measure has bipartisan support and is endorsed by the Wisconsin Dental Association, which represents about 3,000 dentists statewide. It passed the Assembly 89-8 and now heads to the Senate.

The bill would force changes in existing contracts between dentists and insurers so that insurance companies can no longer require dentists to charge in-network patients less for certain services. Current law allows insurance companies to negotiate with dentists to reduce prices charged to patients who are members of that insurance plan.

Bill supporters said under current law, dentists are forced to pass costs of care for one group of patients who have insurance plans requiring discounts along to others who pay out of pocket or don't have coverage. That results in a "hidden tax" on those who pay out of pocket, said Wisconsin Dental Association lobbyist Mara Brooks in a letter to lawmakers urging support.

"This is a real win for small businesses and it's a win for health care consumers," said Rep. Jon Richards, D-Milwaukee.

But WMC lobbyist Chris Reader said the proposed change would make Wisconsin less competitive.

"The wrong message is sent to the business community when the state government starts picking winners and losers in private-party contract disputes," Reader said in the letter to lawmakers. "This legislation would erode the freedom of contract in our state by proposing to legislatively define the terms under which businesses must contract with one another."

The Dental Association, which has worked for years to change the law, said the measure would correct the unfair practice by large insurance plans of dictating the fees for services they don't cover. While many dental benefit plans cover preventative and basic services, most don't cover more costly or cosmetic services like whitening, implants, or veneers, Brooks said in the letter.

The bill is the result of a compromise between dentists and the Alliance of Health Insurers, a coalition of nine major health insurance companies that handle dental claims, said bill sponsor Rep. Joan Ballweg, R-Markesan.

Dentists shouldn't have to foot the bill for services that insurance won't cover and they shouldn't pass the costs on to other patients, she said. The bill brings Wisconsin in line with 30 other states that have adopted similar standards, Ballweg said.

The goal is to have honesty in dental billing, she said.

The bill will help small dental offices that are barred by antitrust laws from joining together to negotiate "meaningful changes" to unfair provisions in their contracts, said Brooks, the Dental Association lobbyist.

Brooks disagreed with WMC's contention that the proposal results in the government creating winners and losers, saying the current climate already makes large corporate insurance plans the winners while small dental practices are the losers.

"This bill would simply help to level the uneven playing field created by current government involvement," Brooks wrote.

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