An act to amend Section 1367.03 of, and to add Section 1374.191 to, the Health and Safety Code, and to amend Section 10133.54 of, and to add Section 10120.6 to, the Insurance Code, relating to health care coverage.
AB 371 would expand California’s dental coverage rules for health care service plans and health insurers. The bill requires plans and insurers that pay contracting dentists directly to also pay noncontracting dentists directly when the patient signs an assignment of benefits form, and it bars reimbursement below a prior authorization or predetermination amount except in cases such as fraud, billing error, or loss of coverage. It also requires out-of-network dentists to make specified disclosures to patients, and requires plans and insurers to notify enrollees or insureds that the out-of-network cost may count toward annual or lifetime maximums and that payment was sent to the provider.
The bill also tightens timely-access and network-adequacy standards for dental coverage. For dental plans and full-service plans offering dental benefits, urgent dental appointments would have to be offered within 48 hours, nonurgent appointments within 18 business days, and preventive dental care within 20 business days. It would require dentists to be available within 15 miles or 30 minutes of an enrollee’s residence or workplace, subject to existing geographic accessibility standards, and would require broader reporting on dental provider networks, including self-insured networks, so regulators can assess adequacy across the full network.
AB 371 would amend Health and Safety Code Section 1367.03 and Insurance Code Section 10133.54, which govern timely access standards for health care service plans and health insurers, and would add new sections 1374.191 and 10120.6 to create the assignment-of-benefits payment rules for dental services. It would also direct the Department of Managed Health Care and the Department of Insurance to review dental network adequacy using more comprehensive network information and would authorize enforcement actions and administrative penalties for noncompliance. The bill states that no reimbursement to local agencies or school districts is required.
The available vote history suggests the bill has had a favorable reception in committee. It passed the Assembly committee vote 15-0 on April 22, 2025, and was then re-referred to Appropriations. There are no committee transcript snippets provided, so the record here shows support but not detailed debate. Overall, the bill appears to be framed as a consumer-protection and access-to-care measure rather than a controversial restructuring of coverage.
The main points of potential contention are likely to be cost, administrative burden, and provider-network compliance. Insurers and plans may object to the tighter appointment standards, broader reporting requirements, and the mandate to pay noncontracting dentists directly when benefits are assigned, while dental providers and patient advocates are likely to support the bill’s payment protections and access requirements. The bill also carves out Medi-Cal managed care dental contracts, which may limit some objections but also narrows its scope.
AB 371 would expand and tighten California’s statutory standards for dental access, network adequacy, and claims payment practices for regulated health care service plans and health insurers. It would create new direct-payment and disclosure requirements for noncontracting dental providers, impose shorter appointment wait-time standards for urgent, nonurgent, and preventive dental care, and require more detailed network reporting and adequacy review by state regulators. The bill would primarily affect dental plans, full-service plans offering dental coverage, and health insurers offering dental benefits, while excluding Medi-Cal managed care dental contracts from the new assignment-of-benefits provisions.
The bill appears to have generally positive momentum in committee, as reflected by a unanimous 15-0 do-pass vote before referral to Appropriations. No committee transcript was provided, so there is no recorded floor of debate to indicate divided views in the available materials. Based on the bill’s content and vote, the overall sentiment seems supportive, with the measure presented as an access-to-care and consumer-protection bill.
Likely areas of contention include whether the new appointment deadlines and geographic standards are operationally feasible for plans and insurers, whether the direct-payment rule for noncontracting dentists could increase costs or encourage out-of-network utilization, and whether the reporting and enforcement provisions create significant administrative burden. Supporters would likely emphasize patient access, transparency, and protection from surprise out-of-network billing dynamics, while opponents would likely focus on cost impacts, network management, and implementation complexity. The exclusion of Medi-Cal managed care dental contracts also suggests the bill is targeted, but that carveout may be relevant to stakeholders concerned about uniformity across programs.