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SB 386

Dental providers: fee-based payments.

2025-2026 Regular Session Introduced by Monique Limón

SB 386 ensures dental providers have a non-fee-based payment option, requiring consent for fee-based methods, enhancing provider autonomy and reducing financial burdens.

Chaptered by Secretary of State. Chapter 219, Statutes of 2025.
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Bill Summary · SB 386

Summary of SB 386: Dental Providers - Fee-Based Payments

Bill Overview

Bill Number: SB 386
Introduced: February 14, 2025
Status: Chaptered by Secretary of State. Chapter 219, Statutes of 2025.
Operative Date: April 1, 2026

SB 386, introduced by Senator Limón, aims to regulate payment methods for dental providers under the Knox-Keene Health Care Service Plan Act of 1975. The bill establishes requirements for health care service plans and health insurers regarding fee-based payment methods.

Purpose and Intent

The primary intent of SB 386 is to ensure that dental providers have a non-fee-based default payment method when receiving payments from health care service plans or insurers. The bill seeks to protect dental providers from incurring fees associated with fee-based payment methods without their explicit consent.

Key Provisions

  1. Default Payment Method:

    • Health care service plans and insurers must provide a non-fee-based default payment method for dental providers.

  2. Affirmative Consent:

    • Dental providers must give affirmative consent (express consent) to opt into a fee-based payment method. This consent must be documented and can be provided via signature or email.
    • Providers can opt out of fee-based payments at any time, and this decision applies to their entire practice and all services covered under their contract.

  3. Information Disclosure:

    • When a dental provider opts into a fee-based payment method, the health care service plan or contracted vendor must provide clear information regarding:
      • Fees associated with the payment method.
      • Alternative payment methods available.
      • Instructions on how to opt out of the fee-based payment method.

  4. Exemptions:

    • The provisions of this bill do not apply if there is a direct contract between the health care service plan or insurer and the dental provider that allows the provider to choose payment methods.

  5. Criminal Penalties:

    • Violations of the bill's requirements by health care service plans will be considered a crime, establishing a state-mandated local program.

Impact

  • Dental Providers: The bill enhances the autonomy of dental providers by ensuring they are not forced into fee-based payment arrangements without their consent, potentially reducing financial burdens.
  • Health Care Service Plans and Insurers: These entities will need to adjust their payment processing systems to comply with the new requirements, ensuring they have non-fee-based options available and that they obtain proper consent from providers.

Procedural Aspects

  • The bill will become operative on April 1, 2026, and will apply to all health care service plan contracts and health insurance policies issued, amended, or renewed on or after that date.
  • The bill passed with a majority vote and was reviewed by various committees before being chaptered.

Conclusion

SB 386 represents a significant step towards protecting dental providers in California by regulating payment methods and ensuring transparency and consent in financial transactions. This legislation aims to foster a fairer and more equitable payment landscape for dental services.

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

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