CDA Fights Dentist Rating Systems Based Solely on Fees

Krysia GabenskiFeatured News

March 16, 2015

Last summer, one of the state’s dental insurance plans implemented a new provider rating system—a three-star “designation” system based solely on treatment fees. Under this rating system, dentists with higher fees for services would get lower ratings, and dentists with lower fees would get higher ratings. During the 2015 legislative session, the CDA is running a bill that would disallow this practice in the future. Far more than simply the cost of care should be included in the design of a provider rating system for the public.

There is an existing Physician Designation Disclosure Act that sets minimum standards for insurer rating systems. This law requires that multiple factors be incorporated into these rating programs – measures like the physician’s quality of care, adjustments for patient population, a reasonable period of data, a robust appeals process and more. This law for physicians sets basic standards to ensure that designation systems are fair, accurate and useful to consumers. However, Colorado’s existing law applies exclusively to physicians. It does not currently apply to other healthcare providers. HB15-1191 would expand this existing law to include dentists.  Colorado Rep. Libby Szabo, Rep. Brittany Pettersen and Sen. Kevin Grantham have sponsored the bill.

On Feb. 26, Dr. Gary Field, CDA president-elect, testified before Colorado’s House Committee on Health, Insurance and Environment, where the bill passed 13-0. The bill has received bipartisan support and has been introduced in the Senate and assigned to the Senate Health and Human Services Committee.