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New California law helps inform patients about dental coverage options, protects dentist-patient relationship in telehealth

Update: CDA-sponsored bill signed into law, takes effect in January 2023

March 31, 2022 3083

Quick Summary:

Gov. Newsom has signed into law CDA-sponsored legislation that requires dental benefit plans that offer services through a third-party telehealth provider to comply with specified notice and consent requirements. The new law will help ensure patients can make the same informed decisions about accessing dental care that they do for their medical care.

Updated Oct. 19, 2022, to reflect that the CDA-sponsored telehealth bill was signed into law. 

As the use of telehealth services continues to increase, patients must be adequately informed about their health plan coverage limitations and options so they can make informed choices about the care they receive. An informed patient not only improves health outcomes but protects the provider-patient relationship. Patients need to be aware of how “triage appointments” could affect their ability to receive the future in-person dental treatment they need.

Legislation signed into law last year provided increased protections in telehealth, but dental benefit plans and insurers were excluded from the bill’s provisions. Now, Gov. Gavin Newsom has signed into law CDA-sponsored Assembly Bill 1982, which removes the dental exemption from last year’s bill.  

Why are telehealth protections for dental patients necessary?

Telehealth is proven to be an effective mode of delivering some types of care, and its use increased considerably at the start of the COVID-19 pandemic. But few and limited dental treatments can be provided remotely through telehealth services, which makes it especially important that dental benefit plans or insurers comply with notice and consent requirements when using third-party corporate telehealth providers.

Dental patients have even been steered by dental benefit plans to use telehealth services instead of in-person services ― often when the patient is experiencing discomfort or pain.  Third-party telehealth providers often operate in a completely virtual environment and may have no relationship with the patient’s local in-network providers. Therefore, patients don’t always receive the important information they need, such as their benefit limitations, frequency limitations and annual maximums. If patients don’t receive that information, they can’t make informed choices about their care. Hence, the provider-patient relationship may suffer.

Ensuring dental patients understand their annual maximums, other plan limitations

By removing the dental exclusion from last year’s bill, known as the Protection of Patient Choice in Telehealth Provider Act, dental benefit plans that offer services through a third-party telehealth provider will be required to comply with specified notice and consent requirements.

“AB 1982 is necessary to ensure patients can make the same informed decisions about accessing dental care that they do for their medical care,” said CDA President Ariane Terlet, DDS. The bill protects the patient-provider relationship and allows for better integration of care.” 

As Californians continue to navigate the pandemic, the use of telehealth services will mean greater access to health care and protection for vulnerable populations, but dental patients need specific protections when using telehealth services that could impact their dental plan limitations before they even see the dentist in person for treatment.

With the passage of AB 1982 by Assemblymember Miguel Santiago (D-Los Angeles), dental plans will be required to notify patients of how third-party telehealth visits could impact their frequency limitations, annual maximums and other limitations of their benefit plan or insurer. 

The new law also requires dental plans to report on the third-party telehealth providers they contract with along with the number and type of dental services delivered. This reporting will help track the growth and utilization of telehealth in dentistry to better enable patient protection. 

Read about additional CDA advocacy, including CDA’s historic 2022 state budget wins for dental workforce development and oral health care access. Watch the newsroom for news about other recent legislation that impacts dentistry.