Third-Party Network Agreements for Dental Services

The bill imposes requirements regarding a contract or agreement between an insurance carrier (carrier) and a third party concerning access to dental care services, including:

• Prohibiting a carrier from entering into a third-party network lease agreement to provide access to dental care services or contractually agreed-upon discounts provided by a dental provider who is contracted as a participating provider (provider) with the carrier, unless the provider gives affirmative consent to allow the third party to access the provider's dental care services and contractually agreed-upon discounts;
• Prohibiting a carrier from canceling a contract with a provider on the grounds that the provider refuses to allow access by a third party to the dental care services and contractually agreed-upon discounts provided by the provider; and
• If a provider allows a third party to access the provider's dental care services and contractually agreed-upon discounts through a contract between a carrier and a third party, requiring the carrier to comply with specified obligations.

The bill create exemptions from the prohibitions on specified contract provisions in contracts between carriers and dental providers, including if:

• A provider network contract for dental services is provided to beneficiaries of programs for medical assistance sponsored by the state of Colorado; or
• Access to a provider network contract is granted to a dental carrier or an entity operating in accordance with the same brand licensee program as the contracting entity, and a list of the carriers or entities with the same brand licensee program as the contracting entity is made available to a provider on the contracting entity's website.(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)