Passing legislation that solves challenges with dental insurance could lead to improved employee satisfaction, reduced administrative burden and elevated patient care, according to one dental practice administrator.
Steven Wilbanks is the practice administrator for the office of Matthew N. Wilbanks, DMD, in Florence, Ala. He recently spoke with Becker’s to share the legislative changes he would like to see made at the state and federal level to improve dentistry.
Note: This response was lightly edited for clarity and length.
Question: What legislation would you like to see passed at the state and/or federal level to solve issues within the workforce or insurance?
Steven Wilbanks: Over the past few years, state-level reform efforts have proven effective in curbing many of the unfair practices that have resulted in increased administrative burden for dental practices (and, in some cases, patients). For instance, many states have passed legislation requiring payers to honor Assignment of Benefits, regardless of the provider’s network status.
This year, I would like to see state legislatures focus on the growing maze of leased networks. These evolving arrangements require significant resources to understand and administer, and many practices (especially smaller private practices) lack the resources to track these arrangements, which payers frequently change with little to no notice. These changes can also take the form of an entire network being purchased abruptly by another carrier, which recently happened here in Alabama with only around 30 days notice. Regardless of their form, these abrupt changes frequently cause issues with benefits and claim processing, making it nearly impossible for practices to have payers truly correct the resulting issues without a dedicated contact at the payer who can assist in these situations. Although some payers focus on developing these relationships with providers, many do not, which contributes to the complexity of this growing issue.
The National Council of Insurance Legislators recently adopted its updated Transparency in Dental Benefits Contracting Model Act that addresses this issue. Aside from the administrative burden that leased networks place on practices, they also directly affect patients by making it impossible for practices to provide accurate cost estimates when they cannot determine the network used by a plan. I would like to see state legislatures adopt this model act as a solution to this, and other growing issues related to the administrative aspect of dental insurance.
Beyond administrative clarity, there is a growing demand from patients for financial accountability regarding how their premium dollars are actually spent. Here in Alabama, two bills were introduced in the state legislature this year (HB 212 and SB 81) that focus on dental loss ratios as part of the Alabama Dental Association’s More for Your Smile legislative package. These bills sought to establish a minimum DLR of 75% for individual plans and 83% for group plans, ensuring that patient care is prioritized over an insurance company’s administrative overhead and profit margins. I believe these reforms are also important so patients can receive the maximum benefits from their plan. Although these bills weren’t passed in the 2026 regular session, I look forward to seeing the benefits of a DLR in Alabama soon.
Despite these state-level reforms, it’s important for stakeholders to understand that many plans are governed by [The Employee Retirement Income Security Act.] Many dental carriers have interpreted this legislation as a type of loophole that allows their plan guidelines to preempt many state laws that govern dental plans. This has effectively created a two-tiered system where fully-insured plans are regulated by state law, while some self-funded plans (the majority of group dental plans in the U.S.) are not, resulting in payers creating and enforcing requirements that directly contradict state laws. In order for any state-level reforms to make a meaningful difference, this gap needs to be closed.
U.S. Reps. Jeff Van Drew, DMD (R-NJ) and Herb Conaway, MD (D-NJ) have introduced a bill in the House that addresses this preemption, titled the Improving Dental Administration Act of 2026 (H.R. 7931). This bill would require payers to follow state laws when no specific federal law exists on a particular matter. This bill’s passage is crucial so that state-level reforms can be enabled to effectively solve many of the insurance-related issues patients and practices are facing. Once this roadblock is removed, states will be able to address these issues more comprehensively in future years.
More broadly, I believe insurance reform will also solve some of the workforce issues the dental industry is currently facing. When practices have a lower administrative burden (and thus a lower cost), they are able to pass that savings along in the form of increased wages. Also, when team members are able to place more of their focus on patient care — not paperwork — their overall happiness and productivity increase, leading to higher employee retention and a growing rate of employees entering the industry. Ultimately, dental insurance reform will positively impact both patients and dental care professionals.
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