Provides that dental insurance coverage shall include coverage for night guards; defines dental night guards; provides that dental night guards shall be covered under Medicaid.
Summary
This bill would require most New York health insurance policies that already cover or reimburse dental services to also cover or reimburse dental night guards when prescribed by a licensed dentist. It adds the same requirement across several insurance law provisions that govern individual, group, and nonprofit health plans, and it defines a night guard as a protective mouth device that covers the teeth and gums to prevent or reduce injury to the teeth, arches, lips, and gums.
The bill also amends the Social Services Law to include dental night guards as a covered Medicaid dental service when prescribed by a licensed dentist. The measure would take effect immediately and apply to policies and contracts issued, renewed, modified, altered, or amended on or after the effective date.
Impact
The bill would expand mandated dental coverage in New York by creating a specific insurance and Medicaid benefit for dental night guards. It would affect insurers offering dental coverage under the Insurance Law and would require Medicaid coverage for the same device under the Social Services Law, likely increasing access for patients who need night guards for dental protection or treatment. Insurers and Medicaid administrators would need to update benefit design, claims processing, and coverage policies to comply.
Sentiment
No committee transcript or recorded vote information was provided, so there is no direct evidence of debate or formal support/opposition in the materials supplied. Based on the bill text and caption, the measure appears consumer- and patient-oriented, aimed at expanding access to a commonly prescribed dental device. The overall framing suggests a straightforward coverage mandate rather than a controversial policy change.
Contention
The main likely point of contention is cost: insurers and Medicaid may object to the added coverage mandate because it could increase utilization and expenditures. Another possible issue is whether the bill should require coverage for all dental night guards or only for certain medically necessary cases, since the text broadly requires coverage whenever prescribed by a licensed dentist. No specific opposing or supporting stakeholders are identified in the provided record.
Same As
Provides that dental insurance coverage shall include coverage for night guards; defines dental night guards; provides that dental night guards shall be covered under Medicaid.
Provides that dental insurance coverage shall include coverage for night guards; defines dental night guards; provides that dental night guards shall be covered under Medicaid.
Provides that dental insurance coverage shall include coverage for night guards; defines dental night guards; provides that dental night guards shall be covered under Medicaid.
An act to amend Section 1680 of the Business and Professions Code, 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.
Addresses non-covered dental services by requiring all policies providing coverage of and all contracts for dental services issued to include a disclosure stating that a participating provider may charge their normal fee for services that are not covered; requires a cost estimate to be provided.
Addresses non-covered dental services by requiring all policies providing coverage of and all contracts for dental services issued to include a disclosure stating that a participating provider may charge their normal fee for services that are not covered; requires a cost estimate to be provided.