Prohibition on Non-Covered Services Fees Enacted in Vermont

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Governor Scott recently signed into law a bill containing one of the long-term priorities of the Vermont State Dental Society (VSDS) members over the last few years: a prohibition on any insurer from setting a fee for non-covered services.

The law (Act 25, page 42) limits the insurers’ ability to dictate the fees you charge. The only time insurers can dictate your fee is when you provide a covered service; which means reimbursement is available or would be available if not for certain contractual limitations. The law further prohibits dental plans from listing fees for non-covered services. Furthermore, the fees they set for covered services must be reasonable.

The new law takes effect on January 1, 2022 and will apply to all contracts and participating provider agreements entered into or renewed on or after that date. VSDS anticipates that as the effective date grows closer, dentists and offices will hear from insurance carriers regarding implementation of the new law.

This achievement reflects a true team effort on the part of many. Special thanks go to Rep. Lynn Dickinson (R-St. Albans Town) for introducing the legislation in the General Assembly, to Dr. Steve Pitmon for providing testimony before both House and Senate Committees in support of the measure and to each dentist who last year reached out expressing support for the bill.

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