Protect Hoosier Patients from Higher Costs
Oppose mandatory AOB in SB 132 to protect Hoosiers from increased costs, diminished choice, and reduced quality-of-care protections.
The Issue
The Solution
Indiana lawmakers should defeat mandatory AOB legislation as it will result in smaller insurer networks, reduced patient choice, increased cost, and fewer patient protections.
Dentists are lobbying for a mandatory Assignment of Benefits (AOB) law so they can have the rewards of participating in an insurer’s provider network without having to abide by reasonable patient cost and quality protections.
When a dentist joins an insurer’s provider network, they agree to accept an insurer’s allowable fee. The patient is protected from “balance billing.”
Provider Networks Save Money.
Insurers require in-network dentists to meet credentialing standards, abide by claims processing policies, and adhere to quality of care standards. These policies offer important cost and treatment safeguards for patients.
Patients who use an in-network provider are better protected.
With mandatory AOB, out-of-network dentists can charge higher fees and avoid other reasonable patient protections, but still receive direct payment from insurers, even without a contractual relationship.
Mandatory AOB creates incentives for dentists to drop out of insurer networks, making it more difficult to for patients to receive in-network care.
Why it Matters
Case Study: Delta Dental
Delta Dental plans play an important role in reducing the cost of dental care for Hoosiers. In 2023, Delta Dental saved its Indiana enrollees and employer groups $150.6 million through in-network care and claims processing policies.
On average, Delta Dental networks are smaller in mandatory AOB states as compared to non-AOB states. In the 10 states with the smallest Delta Dental networks, 7 of the 10 have a mandatory AOB law.
In 2008, Delta Dental of Indiana began disallowing AOB for out-of-network claims. Over the subsequent three years, Delta Dental's dentist network grew from 1,499 dentists (52.5% of all practicing Indiana dentists) to 2,102 dentists (69.9%), an increase of more than 40%.
Since that time, Delta Dental's network has continued to grow and now includes nearly 80% of Indiana dentists. This network growth has saved patients money, improve choice of in-network dentists, and increased quality of care protections for patients. The mandatory AOB portion of SB 132 could undue this progress.
The Indiana Mandated Benefits Task Force, an independent state government commission, previously reviewed the mandatory AOB issue. Its report included the following findings and recommendations:
“Direct payment of claims to participating providers is a key benefit of contracting with a health care payer.”
“Consumers will have no protection from balanced billing with an AOB law.”
“We recommend that the legislature consider providing some consumer protection from unlimited balanced billed charges...”
The General Assembly considered mandatory AOB legislation in 2006, 2007, 2008, 2009, 2010 and 2011. In all cases, state legislators rejected mandatory AOB.