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Dental Insurance Reform
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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.
Member Center
Renew your Membership
Join Us
News
News & Info
News Archive
COVID-19 Updates
NJDA Paparazzi Page
Community Volunteer Programs
Delta Dental's Special Smiles
Give Kids A Smile For Dental Professionals
Frequently Asked Questions
Member Photo Submission
How to Log In
Member Resources
Dental Practice Resources
Third Party Payer Concierge
HIPAA Compliance Software
OSHA Standards
Practice Resources
Classified Ads
Practice Transitions
COVID-19 Updates
Epstein Practice Brokerage
Temporary Staffing
Horizon Blue Cross Blue Shield of NJ
Career Resources
Career Center
Mentor Program
Career Center
Continuing Education
New Dentist Resources
Practice Transitions
TDIC's Risk Management Matters
Financial Resources
ADA Third Party Payer Concierge
Bank of America
Insurance Hub
NJDA PERKS
Membership Directory
Member FAQs
Wellness Resources
Dental Advocacy
Dental Advocacy
Legislative
Dental Insurance Reform
Regulatory
Third Party Payer Concierge
Legal Support
Political Action
Contribute to NJDPAC
2023 NJDPAC Contributors
2022 NJDPAC Contributors
Centurion Club Contributors
NJDPAC Women's Legal, Accounting, and Banking Seminar
NJ Advocacy In The News
CE, Events & Advertising
Calendar
Continuing Education
NJDPAC Women's Legal, Accounting, & Banking Seminar
Social Events
NJDPAC Golf Outing
Commuter Series: How Dentists Get Paid
MATE Act Resource Page
Advertising & Sponsorship
Meeting Facility Rentals
Course Submission Form
Information Sessions with Delta Dental
About Us
NJDA Leadership
Component Societies
Component Resources
NJ Dental Associations
House of Delegates
NJDA Paparazzi Page
History & Mission Statement
Capital Campaign
NJDA Staff
For the Public
Find a Dentist
Why choose an NJDA Dentist?
Dental Clinics & Programs
For Teachers, Homeschoolers & Care Givers
Special Olympics Provider List
Mouth Healthy
Dental Health FAQ
Oral & Systemic Health
Fluoridation
Amalgam
Give Kids A Smile
Volunteer Sign Up
For Parents
For Dental Professionals
give kids a smile forms
GKAS Resources
For Schools, Municipalities and Charitable Groups
Peer Review
Advertising & Sponsorship
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