HB404 Alabama 2015 Session

Summary

Primary Sponsor

Anthony DanielsRepresentative

Democrat

Session

Regular Session 2015

Title

Insurance, health insurance entity, quality rating system for dentists using cost of services, prohibited, criteria for quality rating system

Summary

HB404 would stop health insurance entities from using the cost of dental services to rate dentists and would set criteria for any quality rating system.

What This Bill Does

If enacted, the bill would prohibit health insurance entities that provide dental coverage from establishing a quality rating system for dentists based on cost of services. Any quality rating system would have to use verified, transparent, fair data that is accessible to both dentists and consumers and publicly disclosed. The data must come from nationally recognized evidence-based or consensus guidelines and include patient population characteristics (such as types of cases, severity, comorbidities, and the role of patient compliance) with dental-record verifications to ensure accuracy. The act would take effect on the first day of the third month after passage and governor approval.

Who It Affects

• Health insurance entities that provide dental coverage would be restricted from using cost-based quality ratings for dentists and must follow the new data criteria.
• Dentists and the general public (consumers) would have access to transparent, verified rating data and public disclosure of quality information.

Key Provisions

• Prohibits a health insurance entity from establishing a quality rating system for dentists using cost of services.
• Requires any quality rating system to be based on data that is verified for accuracy, transparent, fair, accessible to dentists and consumers, and disclosed to the public.
• Demands data be derived from nationally recognized evidence-based or consensus-based clinical guidelines and include patient population characteristics (e.g., types of cases, severity, comorbidity, and impact of patient compliance) with sufficient dental-record verifications to ensure accuracy.
• Defines 'health insurance entity' as any entity providing dental coverage that is licensed by the Department of Insurance or organized under Article 6 of Chapter 20 of Title 10A of the Alabama Code.
• Establishes the act's effective date as the first day of the third month following passage and governor approval.

AI-generated summary using openai/gpt-5-nano on Feb 24, 2026. May contain errors — refer to the official bill text for accuracy.

Subjects

Insurance