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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. 
 2002 Allows 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

 2003  Allows 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

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

 2006  Requires 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

 2006  Limits 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

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

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

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

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

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

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

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

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

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

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

 2023  Allows 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.

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