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*hb1091*
HOUSE BILL 1091
J5 6lr1981
CF SB 813
By: Delegate Kerr Delegates Kerr, Alston, Bagnall , Cullison, Guzzone, Hill,
Hutchinson, S. Johnson, Kaufman, Kipke, Lopez, Martinez, M. Morgan,
Reilly, Rosenberg, Ross, Szeliga, Taveras, White Holland, and Woorman
Introduced and read first time: February 11, 2026
Assigned to: Health
Committee Report: Favorable with amendments
House action: Adopted
Read second time: March 3, 2026
CHAPTER ______
AN ACT concerning 1
Health Insurance and Dental Plan Organizations – Dentists – Assignment of 2
Benefits and Reimbursement of Nonpreferred Providers 3
FOR the purpose of prohibiting certain insurers and dental plan organizations from 4
prohibiting an assignment of benefits to a provider who is a dentist by an insured or 5
refusing to directly reimburse a nonpreferred provider who is a dentist; requiring a 6
nonpreferred provider who is a dentist and who seeks an assignment of benefits from 7
an insured or enrollee to provide certain information to the insured or enrollee before 8
performing a health care service and submit a disclosure form to document the 9
assignment of benefits; authorizing certain insurers and dental plan organizations 10
to refuse to directly reimburse a nonparticipating provider who is a dentist under 11
certain circumstances; and generally relating to insurance coverage for dental 12
services. 13
BY repealing and reenacting, without amendments, 14
Article – Insurance 15
Section 14–201(a) 16
Annotated Code of Maryland 17
(2017 Replacement Volume and 2025 Supplement) 18
BY repealing and reenacting, with amendments, 19
Article – Insurance 20
Section 14–201(p) and (r) and 14–205.3 21
2 HOUSE BILL 1091
Annotated Code of Maryland 1
(2017 Replacement Volume and 2025 Supplement) 2
BY adding to 3
Article – Insurance 4
Section 14–410.1 5
Annotated Code of Maryland 6
(2017 Replacement Volume and 2025 Supplement) 7
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 8
That the Laws of Maryland read as follows: 9
Article – Insurance 10
14–201. 11
(a) In this subtitle the following words have the meanings indicated. 12
(p) “Provider” means a physician, DENTIST, hospital, or other person that is 13
licensed or otherwise authorized to provide health care services. 14
(r) “Similarly licensed provider” means: 15
(1) for a physician: 16
(i) a physician who is board certified or eligible in the same practice 17
specialty; or 18
(ii) a group physician practice that contains board certified or 19
eligible physicians in the same practice specialty; [or] 20
(2) FOR A DENTIST: 21
(I) A DENTIST LICENSED T O PRACTICE DENTISTRY IN THE 22
STATE UNDER TITLE 4 OF THE HEALTH OCCUPATIONS ARTICLE WHO PE RFORMS 23
THE SAME OR SIMILAR DENTAL SERVICES; OR 24
(II) A GROUP DENTAL PRACT ICE THAT CONSISTS OF DENTISTS 25
LICENSED IN THE STATE UNDER TITLE 4 OF THE HEALTH OCCUPATIONS ARTICLE 26
WHO PERFORM THE SAME OR SIMILAR DENTAL SERVICES; OR 27
[(2)] (3) for a health care provider OR DENTIST who is not a physician 28
OR DENTIST, a health care provider OR DENTIST who holds the same type of license or 29
certification. 30
14–205.3. 31
HOUSE BILL 1091 3
(a) This section does not apply to on–call physicians or hospital–based physicians. 1
(b) An insurer may not: 2
(1) prohibit the assignment of benefits to a provider who is a physician OR 3
DENTIST by an insured; or 4
(2) refuse to directly reimburse a nonpreferred provider who is a physician 5
OR DENTIST under an assignment of benefits. 6
(c) If an insured has not provided an assignment of benefits, the insurer shall 7
include the following information with the payment to the insured for health care services 8
rendered by the nonpreferred provider who is a physician OR DENTIST: 9
(1) the specific claim covered by the payment; 10
(2) the amount paid for the claim; 11
(3) the amount that is the insured’s responsibility; and 12
(4) a statement instructing the insured to use the payment to pay the 13
nonpreferred provider in the event the insured has not paid the nonpreferred provider in 14
full for the health care services rendered by the nonpreferred provider. 15
(d) If a physician OR DENTIST who is a nonpreferred provider seeks an 16
assignment of benefits from an ins ured, the physician OR DENTIST shall provide the 17
following information to the insured, prior to performing a health care service: 18
(1) a statement informing the insured that the physician OR DENTIST is a 19
nonpreferred provider; 20
(2) a statement informing the insured that the physician OR DENTIST may 21
charge the insured for noncovered services; 22
(3) a statement informing the insured that the physician OR DENTIST may 23
charge the insured the balance bill for covered services; 24
(4) an estimate of the cost of services that the physician OR DENTIST will 25
provide to the insured; 26
(5) any terms of payment that may apply; and 27
(6) whether interest will apply and, if so, the amount of interest charged 28
by the physician OR DENTIST. 29
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(e) A physician OR DENTIST who is a nonpreferred provider shall submit the 1
disclosure form developed by the Commissioner under subsection (f) of this section to 2
document to the insurer the assignment of benefits by an insured. 3
(f) The Commissioner shall deve lop disclosure forms to implement the 4
requirements under subsections (c) and (d) of this section. 5
(g) Notwithstanding the provisions of subsection (b) of this section, an insurer 6
may refuse to directly reimburse a nonpreferred provider under an assignmen t of benefits 7
if: 8
(1) the insurer receives notice of the assignment of benefits after the time 9
the insurer has paid the benefits to the insured; 10
(2) the insurer, due to an inadvertent administrative error, has previously 11
paid the insured; 12
(3) the insured withdraws the assignment of benefits before the insurer 13
has paid the benefits to the nonpreferred provider; or 14
(4) the insured paid the nonpreferred provider the full amount due at the 15
time of service. 16
14–410.1. 17
(A) IN THIS SECTION, “DENTIST” MEANS AN INDIVIDUAL LICENSED UNDER 18
TITLE 4 OF THE HEALTH OCCUPATIONS ARTICLE. 19
(B) EXCEPT AS PROVIDED IN SUBSECTION (G) OF THIS SECTION, A DENTAL 20
PLAN ORGANIZATION MAY NOT: 21
(1) PROHIBIT THE ASSIGNM ENT OF BENEFITS TO A DENTIST BY AN 22
ENROLLEE; OR 23
(2) REFUSE TO DIRECTLY R EIMBURSE A NONPREFER RED DENTIST 24
UNDER AN ASSIGNMENT OF BENEFITS. 25
(C) IF AN ENROLLEE HAS NO T PROVIDED AN ASSIGN MENT OF BENEFITS , 26
THE DENTAL PLAN ORGANIZATION SHALL INCLUDE THE FOLLOWING INFORMATION 27
WITH THE PAYMENT TO THE ENROLLEE FOR DENTAL SERVICES RENDERED BY THE 28
NONPREFERRED DENTIST: 29
(1) THE SPECIFIC CLAIM COVERED BY THE PAYMENT; 30
(2) THE AMOUNT PAID FOR THE CLAIM; 31
HOUSE BILL 1091 5
(3) THE AMOUNT THAT IS T HE ENROLLEE’S RESPONSIBILITY OF THE 1
DENTAL PLAN ORGANIZATION; AND 2
(4) A STATE MENT INSTRUCTING THE ENROLLEE TO USE THE 3
PAYMENT TO PAY THE NONPREFERRED DENTIST IN THE EVENT THAT THE ENROLLEE 4
HAS NOT PAID THE NON PREFERRED DENTIST IN FULL FOR DENTAL SERV ICES 5
RENDERED BY THE NONPREFERRED DENTIST. 6
(D) IF A NONPREFERRED DEN TIST SEEKS AN ASSIGNMENT OF BENEFI TS 7
FROM AN ENROLLEE, THE DENTIST SHALL PROVIDE THE FOLLOWING INFORMATION 8
TO THE ENROLLEE BEFORE PERFORMING A DENTAL SERVICE: 9
(1) A STATEMENT INFORMING THE ENROLLEE THAT THE DENTIST IS 10
A NONPREFERRED DENTIST; 11
(2) A STATEMENT INFORMIN G THE ENROLLEE THAT THE DENTIST 12
MAY CHARGE THE ENROLLEE FOR NONCOVERED SERVICES; 13
(3) A STATEMENT INFORMIN G THE ENROLLEE THAT THE DENTIST 14
MAY CHARGE THE ENROLLEE THE BALANCE BILL FOR COVERED SERVICES; 15
(4) AN ESTIMATE OF THE COST OF SERVICES THAT THE DENTIST WILL 16
PROVIDE TO THE ENROLLEE; 17
(5) ANY TERMS OF PAYMENT THAT MAY APPLY; AND 18
(6) WHETHER INTEREST WIL L APPLY AND , IF SO , THE AMOUNT OF 19
INTEREST CHARGED BY THE DENTIST. 20
(E) A NONPREFERRED DENTIST SHALL SUBMIT THE DIS CLOSURE FORM 21
DEVELOPED BY THE COMMISSIONER UNDER SUBSECTION (F) OF THIS SECTION TO 22
DOCUMENT TO THE DENT AL PLAN ORGANIZATION THE ASSIGNMENT OF BE NEFITS 23
BY THE ENROLLEE. 24
(F) THE COMMISSIONER SHALL DE VELOP THE FORMS NECE SSARY TO 25
IMPLEMENT THIS SUBSECTION SECTION. 26
(G) A DENTAL PLAN ORGANIZATION MAY REFUSE TO DIRECTLY REIMBURSE 27
A NONPREFERRED DENTIST UNDER AN ASSIGNMENT OF BENEFITS IF: 28
6 HOUSE BILL 1091
(1) THE DENTAL PLAN ORGA NIZATION RECEIVES NO TICE OF THE 1
ASSIGNMENT OF BENEFITS AFTER THE TIME THE DENTAL PLAN ORGANIZATION HAS 2
PAID THE BENEFITS TO THE ENROLLEE; 3
(2) THE ENROLLEE WITHDRA WS THE ASSIGNMENT OF BENEFITS 4
BEFORE THE DENTAL PL AN ORGANIZATION HAS PAID THE BENEFITS TO THE 5
NONPREFERRED DENTIST; OR 6
(3) THE ENROLLEE PAID TH E NONPREFERRED DENTI ST THE FULL 7
AMOUNT DUE AT THE TIME OF SERVICE. 8
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 9
January 1, 2027. 10
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.