From the latest on COVID vaccines and policy to recent court rulings, FYI brings you the biggest dental policy stories.

1. California law may expand dental coverage

A new law may open the door for some California adults and seniors to obtain dental insurance.

Set to take effect in 2023, California Assembly Bill 570, or the Parent Healthcare Act, will allow adult children to add their dependent parents and stepparents to their individual major medical insurance plans. The state estimates that as many as 15,000 people might be covered under the new law, which has no age limitations.

The law applies only to individual medical plans, including those that offer dental coverage, and doesn’t apply to specialized health care service plans that cover only dental. Employer-sponsored plans and Medicare supplement insurance are also excluded.

2. New federal law requires dentists to provide cost estimates to certain patients

The No Surprises Act, which went into effect Jan. 1, gives uninsured and self-pay consumers certain billing protections. Most notably for dentists, the act requires that many dentists, including those who practice in private dental offices, provide good faith estimates for the cost of care to these patients if they request them or schedule service.

  • After the request is made or service is scheduled, dentists and facilities must provide the good faith estimate in writing within three business days. Either a paper or printable electronic copy of the estimate is required.
  • If the actual charges exceed the estimate by $400 or more, the patient or an authorized representative can initiate a patient-provider dispute resolution process and seek a determination from an independent third-party certified by the United States Department of Health and Human Services.

There are no specific specialties, facilities or service sites that are exempt from this requirement, according to the Centers for Medicare & Medicaid Services (CMS). However, the requirement doesn’t apply to patients with coverage through Medicare, Medicaid, the Indian Health Service, Veterans Affairs Health Care or TRICARE.

For questions about good faith estimates and the dispute resolution process, CMS has provided this guidance to dentists and facilities.

3. Court blocks large-employer vaccine mandate, upholds mandate for federal facilities

Two recent decisions by U.S. Supreme Court concerning the COVID-19 vaccine may affect dental offices. The court ruled on Jan. 13 to block a federal mandate that required large employers (such as dental practices with 100 or more employees) to ensure that all their employees either received the COVID-19 vaccine or wear facemasks and submit to weekly tests.

Conversely, the court upheld a mandate that requires staff at federally funded health care facilities to receive the COVID-19 vaccine. The rule affects certain dentists, including those who work in Medicare or Medicaid facilities such as nursing homes, surgical centers and hospitals. However, the ruling excludes private dental practices that serve Medicare or Medicaid patients.