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H 1174

An Act to create direct dental care agreements

194th Legislature (2025-2026) Introduced by Homar Gomez

Allows dentists and patients to use periodic-fee direct dental care agreements for defined services, outside insurance and without insurance regulation.

Hearing scheduled for 10/27/2025 from 10:30 AM-04:00 PM in Gardner Auditorium
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Bill Summary · H 1174

Comprehensive Summary: H.1174 — An Act to create direct dental care agreements

Overview

H.1174 proposes creating a new statutory framework for direct dental care arrangements in Massachusetts. The bill would add a new Section 53A to Chapter 112, allowing dentists and patients to enter into direct dental care agreements based on periodic fees for defined services, rather than traditional fee-for-service arrangements funded by dental insurance. The bill clarifies that these agreements are not insurance products and would not fall under the oversight of the Massachusetts Division of Insurance.

Key Provisions

  • Definitions (Section 53A(a))

    • “Dentist”: licensed to practice dentistry (per current law).
    • “Direct dental care”: screening, assessment, and diagnosis of oral health and disease.
    • “Direct dental care agreements”: agreements for the delivery of direct dental care between a dentist and patient, financed by a periodic fee for specified services over a set period, separate from insurance-based payment models.
    • “Patient”: individual contracting for dental care.

  • Authorization and requirements (Section 53A(b))

    • A dentist and patient may enter into a direct dental care agreement for direct dental care.
    • The agreement must specify: (i) the services provided in exchange for the periodic fee; (ii) the periodic fee and any additional charges; (iii) that termination of the agreement does not affect other agreements entered under this section; (iv) that the dentist may not submit fee-for-service claims for services covered under the agreement.

  • Regulatory status (Section 53A(c))

    • Dentists entering into direct dental care agreements are not considered insurance companies and are not subject to oversight by the Division of Insurance or to subsection 5 of section 52A.
    • Direct dental care agreements are not considered insurance products or plans and are not subject to the same insurance oversight.

Who Would Be Affected

  • Dentists and dental practices: could offer direct dental care agreements as a service model outside traditional insurance reimbursement.
  • Patients/consumers: could enroll in periodic-fee agreements for specified dental services, potentially changing how some dental services are financed and delivered.
  • Regulatory bodies: Division of Insurance would not oversee these agreements under the bill.

Timeline and Legislative Actions

  • Introduced: February 27, 2025; referred to the Committee on Financial Services.
  • Related action: Senate concurred on the same date as indicated; House docket references similar or prior versions (e.g., HD 335; prior session HD 965).
  • Hearing: Scheduled for October 27, 2025, from 10:30 AM to 4:00 PM in Gardner Auditorium.

Related Context

  • Similar matter previously filed in earlier sessions, indicating ongoing consideration of direct dental care models.
  • The act would take effect upon enactment if passed, with details to be specified in the final enacted text.

Bottom Line

H.1174 formalizes a direct dental care framework, enabling periodic-fee agreements between dentists and patients and clarifying that such arrangements are not insurance products or subject to insurance regulation. The bill emphasizes service scope, fee disclosure, and the separation of these agreements from fee-for-service insurance claims. It introduces potential shifts in financing and delivery of dental care while preserving certain protections by excluding direct care agreements from insurance oversight.

Compiled from official sources — confirm details with the bill’s official record.

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