A bill for an act relating to prior authorization for dental care services, notice to dental care providers that a dental care service plan is state-regulated, and the recovery of overpayments by a dental carrier. (Formerly SSB 1146.) Effective date: 07/01/2025
The bill introduces a series of new requirements for dental carriers, including the obligation to inform providers whether the covered person's dental service plan is subject to state insurance laws. Additionally, starting July 1, 2025, the identification cards issued to covered persons must clearly state that their plan is state-regulated. This is intended to provide clarity and assurance to dental care providers about the regulatory framework governing the dental services they deliver.
Senate File 470 (SF470) is a legislative act focused on the regulation of dental care services in Iowa. It establishes guidelines for prior authorization of dental care services, ensuring that dental carriers cannot deny claims for services previously authorized. The bill mandates that dental providers are reimbursed at the agreed-upon rates for services covered by prior authorization. It aims to enhance the transparency and reliability of dental insurance processes for providers and patients alike.
Notable points of contention surrounding SF470 may include potential disagreements over how reforms could affect the operational flexibility of dental carriers and their interactions with providers. Providers may support the bill due to the improved guarantees around reimbursement for authorized services, while dental insurers might argue that increased regulations could complicate their ability to manage costs effectively. Moreover, the prohibition against waiving any contract terms that are contrary to the bill may further spark debate around contractual autonomy for dental carriers and providers.