DeLuca: Dental networks have value and keep costs down for the consumer

HARRISBURG, Sept. 23 – On Sunday, I read Kailyn Marie Perez’s “As I See It” editorial on ways lawmakers can reform health care. While I appreciate and respect her opinion, as Democratic chairman of the House Insurance Committee, I feel that it’s my duty to provide readers with the other side of the story.

First, dental networks have value and keep costs down in order to prevent premium increases for dental coverage. This keeps consumers from shelling out big money on top of what their dental insurer reimburses for services.

What is missing from the previous Sunday story is the fact that out-of-network dentists generally choose not to join the network because they don’t want a contract and won’t have to agree to in-network reimbursement rates. They want direct payment so they can balance bill the consumer the difference between the reimbursement and the original charges. Meaning – the consumer pays more!  

I have consistently said no to this proposal and, when House Bill 564 came up for a committee vote, all House Democrats voted “no” and even some Republicans voiced concern, too.

The Dental Association that is pushing this proposal wants their cake so they can eat it, too. Dentists would benefit from direct payment when out of network, while the consumer does not benefit. How does a consumer benefit from being balance billed additional charges?

Even if we considered direct payment to out-of-network dentists, I would continue to fight for no balance billing to protect you, the consumer. Nothing in the proposed legislation (H.B. 564) would prevent your current in-network dentist who accepts their contractual payment as payment in full (except for your normal cost sharing of co-payment, co-insurance and deductibles) from simply dropping out of networks, while still receiving direct payment for being out of network and balance billing you further charges.

The bottom line is you would pay more for services, and that sounds like a bad deal to me! So, call your legislator and ask him or her to vote “no” on H.B. 564!