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AB 371

Dental coverage.

2025-2026 Regular Session Introduced by Dawn Addis and 2 co-sponsors

AB 371 requires faster dental appointments, waits within 18 days nonurgent and 20 days preventive, and 15‑mile access, plus enables out‑of‑network payments and stronger network rep

In committee: Held under submission.
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Bill Summary · AB 371

AB 371 (Haney) — Summary: Dental coverage (2025)

Purpose

AB 371 strengthens timely access, payment, transparency, and network adequacy rules for dental services covered by health care service plans and health insurers in California. The bill amends Health and Safety Code section 1367.03 and adds requirements intended to reduce wait times for dental appointments, increase geographic access, enable assignment of benefits to out‑of‑network dentists in some circumstances, and expand reporting and oversight of dental networks.

Key provisions

  • Timely access standards (dental-specific)
    • Urgent dental appointments (no prior authorization): within 48 hours of request (previously 72 hours).
    • Urgent dental appointments (require prior authorization): within 96 hours of request.
    • Nonurgent dental appointments: within 18 business days of request (previously 36 business days).
    • Preventive dental care appointments: within 20 business days of request (previously 40 business days).
  • Geographic accessibility
    • Dentists must be available within 15 miles or 30 minutes of an enrollee’s/insured’s residence or workplace and are subject to the relevant department’s geographic accessibility standards.
  • Assignment of benefits and out‑of‑network payment
    • If a plan/insurer pays contracting dental providers directly, it must also pay a noncontracting dental provider directly for covered services when the noncontracting provider submits a written assignment of benefits signed by the enrollee/insured.
    • Plans/insurers must provide a predetermination or prior authorization to the provider and reimburse the provider at least the predetermination/authorized amount (with exceptions as specified in the bill).
    • Plans/insurers must notify the enrollee/insured that the provider was paid and that the out‑of‑network cost may count toward the enrollee’s/insured’s annual or lifetime maximum.
    • Noncontracting providers must make certain specified disclosures to the enrollee/insured before accepting an assignment of benefits.
  • Network reporting and oversight
    • Plans and insurers must report comprehensive information about the networks each dental provider serves, including a plan’s/insurer’s self‑insured network.
    • The Department of Managed Health Care (DMHC) and the Department of Insurance (DOI) must review the adequacy of entire dental provider networks, including portions that serve plans/insurers not regulated by the reviewing department.

Who is affected

  • Enrollees and insureds with dental benefits (potentially shorter waits and improved geographic access).
  • Contracting and noncontracting dental providers (new payment and disclosure rules; possible changes in patient mix and billing).
  • Health care service plans and health insurers (new timely‑access targets, reporting obligations, payment and notification duties).
  • DMHC and DOI (expanded oversight responsibilities).

Procedural status & timeline

  • Introduced: February 3, 2025.
  • Committees: Referred to Assembly Health (Feb 18), amended and re-referred; to Assembly Appropriations (re-referred Apr 28).
  • Actions: Amended in committee (April 2025); read second time and amended Apr 24; set for first hearing and referred to suspense file; held under submission in Assembly Appropriations as of May 23, 2025.
  • Fiscal committee review required (fiscal committee: YES). The bill notes it creates a state‑mandated local program but states no reimbursement is required for a specified reason.

Potential impacts (high level)

  • Could improve timely access to dental care and reduce travel/wait burdens for patients.
  • May increase administrative and payment obligations for plans/insurers and reporting burdens.
  • Assignment‑of‑benefits provisions could shift payment pathways and affect out‑of‑network billing and enrollee cost exposure (because out‑of‑network costs may count toward plan limits).
  • Expanded oversight may surface network adequacy issues across plan types and increase regulatory enforcement.

This summary highlights the bill’s core changes; readers should consult the bill text for complete legal language and any cross‑referenced regulatory provisions.

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

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