Dental providers: fee-based payments.

Senator Limón's dental provider payment legislation establishes new requirements for how health plans and insurers process payments to dental providers, mandating non-fee-based payment as the default method starting April 1, 2026. The bill requires health plans and insurers to obtain explicit consent from dental providers before implementing any fee-based payment arrangements.

Under the new provisions, dental providers maintain the ability to opt in or out of fee-based payment methods at any time through written affirmative consent. When providers opt into fee-based payments, plans and insurers must disclose all associated fees, available payment alternatives, and instructions for opting out. The payment method choice applies across a provider's entire practice and all covered services under their contract.

The legislation exempts situations where health plans or insurers have direct contracts with providers that already allow payment method selection. For non-exempt arrangements, plans and insurers must ensure their contracted payment vendors comply with the consent requirements and disclose any profit-sharing or fee arrangements between the vendor and the plan or insurer.