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SB 813

Health Insurance and Dental Plan Organizations - Dentists - Assignment of Benefits and Reimbursement of Nonpreferred Providers

2026 Regular Session Introduced by Antonio Hayes

SB 813 revises Maryland dental insurance rules governing out-of-network provider reimbursement and benefit assignment to clarify patient costs and insurer payment obligations.

Approved by the Governor - Chapter 737
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Bill Summary · SB 813

Legislative bill overview

SB 813 modifies Maryland's regulations governing how dental insurance plans handle assignment of benefits and reimbursement for non-preferred (out-of-network) dentists. The bill establishes new rules for direct payment arrangements between insurers and dentists, and determines how patients and providers are reimbursed when using dentists outside an insurance plan's network.

Why is this important

Dental care costs are a major healthcare expense for many Maryland residents, and out-of-network dental visits can result in significant unexpected costs. This bill directly affects how much patients pay out-of-pocket versus what insurance covers, and influences dentists' willingness to treat patients with insurance plans, potentially impacting access to dental care.

Potential points of contention

  • Patient financial liability: Clarifying assignment of benefits rules could shift financial responsibility between patients and insurers, potentially increasing or decreasing out-of-pocket costs depending on the specific amendments
  • Provider compensation: Mandated reimbursement rates for non-preferred providers may pressure dental insurers' profits while affecting which dentists accept insurance plans
  • Network adequacy: Stricter rules on out-of-network reimbursement could influence whether dentists join insurance networks, affecting patient choice and network availability in certain areas

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

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