21 Years of Dental Insurance Reform in New Jersey

The New Jersey Dental Association, thanks to the support of over 4,500 member-dentists, has been at the forefront of the drive to change dental insurance for more than 21 years.

2002Allows physicians & dentists to jointly negotiate with health benefits plans over contractual terms and conditions. – Physician/Dentist Joint Insurance Negotiation Law VIEW

2002"Health and Dental Claims Authorization, Processing and Payment Act." – Prompt Payment Reform Law VIEW

2003Allows covered persons with out-of-network benefits in dental and health service corporations and dental plan organization plans to assign dental benefits to dentists of choice. – Dental Benefit Notification Law VIEW

2005Makes various revisions to the "Dental Plan Organization Act." – Modernized the DPO Act Legislation VIEW

2006Requires certain persons making dental decisions regarding insurance coverage to be licensed by the New Jersey State Board of Dentistry. – Regulates Dental Consultants who make adverse decisions law VIEW

2006Limits period for reimbursement for overpayment on health and dental claims to 180 days, establishes claims appeal process, requires examination of claims processing and payment records, and imposes penalties for violations. – Overpayment Rule Legislation VIEW

2008Requires dental benefits coverage for dental composite restorations. – Composite Coverage Legislation VIEW

2012Requires dental plans to make out-of-network payments based on assignment of benefits. – Assignment of Benefits Law VIEW

2014Prohibits insurers from setting prices for non-covered dental services. – Non-Covered Services Law VIEW

2017Requires acceptance of universal dentist application for participation form by dental plan carriers. - Dentist Universal Credentialing Law VIEW

2018Prohibits sale or lease of access to certain health care provider networks. – Leased Network Prohibition Law VIEW

2020/2022Prohibits certain provisions in agreements between insurance carriers and dentists. – Prohibits Disallow Clause Usage by Dental Plans Legislation VIEW

2020Requires dental insurers to provide credits for reduced usage during coronavirus disease 2019 pandemic. Dental Policyholder Credit Law VIEW

2020/2022Requires insurance carriers offering dental benefit plans to provide certain level of coverage and reimbursement. – Modernize Dental Plans Legislation VIEW

2022Prohibits carriers from offering dental plans with dental benefit waiting periods. – Dental Benefit Usage Legislation VIEW

2022Requires health insurance carriers to reimburse health care providers using check or electronic funds transfer. – Virtual Credit Card Ban Legislation VIEW

2023Allows health care providers, including dentists, to jointly negotiate with health benefits plans over contractual terms and conditions. – Health Care Provider Joint Insurance Negotiation Legislation VIEW

By being an NJDA member you are helping protect your profession and advance oral health. Thank you!


View more legislation on which the NJDA is lobbying by clicking HERE.

Click here ada.org/advocacy to view the ADA’s efforts at the federal level.

Contribute to NJDPAC