AB1629 - Dental coverage.

Amended IN Senate August 20, 2026 Amended IN Senate June 25, 2026 Amended IN Senate June 03, 2026 CALIFORNIA LEGISLATURE— 2025–2026 REGULAR SESSION Assembly Bill No. 1629 Introduced by Assembly Member Haney (Coauthor: Assembly Member Addis) January 26, 2026 An act to amend Section 1680 Sections 1680 and 1950.5 of the Business and Professions Code, to amend Section 1367.03 of, and to add Section 1374.191 to, the Health and Safety Code, and to amend Section 10133.54 of, and to add Section 10120.6 to, the Insurance Code, relating to health care coverage. LEGISLATIVE COUNSEL'S DIGEST AB 1629, as amended, Haney. Dental coverage. Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act’s requirements a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law prohibits a contract between a plan or insurer and a dentist from requiring a dentist to accept an amount set by the plan or insurer as payment for dental care services provided to an enrollee or insured that are not covered services under the enrollee’s contract or the insured’s policy. Existing law requires a plan or insurer to make specified disclosures to an enrollee or insured regarding noncovered dental services. Existing law requires a health care service plan or health insurer to comply with specified timely access requirements. Under existing law, a health care service plan is required to annually report to the Department of Managed Health Care on this compliance. Existing law authorizes the Department of Insurance to issue guidance to insurers regarding annual timely access and network reporting methodologies. This bill would require a plan or insurer, including a specialized plan or insurer, covering dental services, upon written and dated consent of the enrollee or insured, to pay a noncontracting dental provider provider, which includes a registered dental hygienist in alternative practice, directly for covered services rendered to the enrollee or insured in accordance with the benefit provided in the contract or policy. policy when the noncontracting dental provider submits to the plan or insurer an assignment of benefits. The bill would require a noncontracting dental provider to obtain a signed and dated consent to collect an assignment of benefits from an enrollee or insured. The bill would prohibit a noncontracting dental provider accepting collecting an enrollee’s or insured’s assignment of benefits from charging an enrollee or insured, prior to the plan or insurer payment, more than an estimate of the enrollee’s or the insured’s cost sharing for the treatment or a deposit that approximates that cost share. The bill would require a noncontracting dental provider to make specified disclosures to an enrollee or insured before accepting an assignment of benefits. Because a willful violation of these provisions relative to health care service plans would be a crime, this bill would impose a state-mandated local program. This bill would require a plan or insurer to certify, under penalty of perjury, that specified information submitted to its regulator regarding network adequacy is true and correct, thus creating a crime and imposing a state-mandated local program. Existing law, the Dental Practice Act, provides for the licensure and regulation of dentists and dental assistants by the Dental Board of California and the licensure and regulation of dental hygienists by the Dental Hygiene Board of California, and defines unprofessional conduct by a licensee, including, among other things, the violation of any provision of the act. Existing law authorizes the respective board to discipline a licensee under the act by placing the licensee on probation under various specified terms and conditions. This bill would require a noncontracting dental provider, including a registered dental hygienist in alternative practice, to make specified disclosures to a patient before collecting the patient’s signed and dated consent to an assignment of benefits. The bill would expand the definition of unprofessional conduct under the act to include the failure to comply with the requirements and prohibitions described above relating to the payment of a noncontracting provider by a plan or insurer, the amount a noncontracting provider may charge an enrollee or insured, and the provision of disclosures by a noncontracting provider. that disclosure requirement and the above-described prohibition relating to the charging of a patient more than an estimate of their cost sharing and the failure to maintain a signed and dated copy of the patient’s consent. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason. Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YES Bill Text The people of the State of California do enact as follows: SECTION 1. The Legislature finds and declares all of the following: (a) It is the intent of the Legislature to hold dental plans and insurers accountable for meeting network adequacy requirements. (b) Nearly one-half of Californians with commercial dental plans have coverage that is self-insured, administrative services only, or managed by a third-party administrator, which have not been included in the state’s assessment of network adequacy for fully insured coverage, despite the large overlap of provider networks serving both self-insured and fully insured dental plans and insurers. (c) Provider network adequacy is more clearly established by commercial dental plans and insurers accurately assessing and ensuring that their reporting data includes all enrollees, including those under self-funded or administrative services-only coverage. (d) This act is not intended to provide the state with authority to regulate dental plans or insurers outside of its current jurisdiction. (e) The Legislature does not intend to prevent the Department of Managed Health Care or the Department of Insurance from developing additional standards or audit methodologies for network adequacy purposes. SEC. 2. Section 1680 of the Business and Professions Code is amended to read: 1680. Unprofessional conduct by a person licensed under this chapter is defined as, but is not limited to, any one of the following: (a) The obtaining of any fee by fraud or misrepresentation. (b) The employment directly or indirectly of any student or suspended or unlicensed dentist to practice dentistry as defined in this chapter. (c) The aiding or abetting of any unlicensed person to practice dentistry. (d) The aiding or abetting of a licensed person to practice dentistry unlawfully. (e) The committing of any act or acts of sexual abuse, misconduct, or relations with a patient that are substantially related to the practice of dentistry. (f) The use of any false, assumed, or fictitious name, either as an individual, firm, corporation, or otherwise, or any name other than the name under which the person is licensed to practice, in advertising or in any other manner indicating that the person is practicing or will practice dentistry, except that name as is specified in a valid permit issued pursuant to Section 1701.5. (g) The practice of accepting or receiving any commission or the rebating in any form or manner of fees for professional services, radiograms, prescriptions, or other services or articles supplied to patients. (h) The making use by the licensee or any agent of the licensee of any advertising statements of a character tending to deceive or mislead the public. (i) The advertising of either professional superiority or the advertising of performance of professional services in a superior manner. This subdivision shall not prohibit advertising permitted by subdivision (h) of Section 651. (j) The employing or the making use of solicitors. (k) The advertising in violation of Section 651. (l) The advertising to guarantee any dental service, or to perform any dental operation painlessly. This subdivision shall not prohibit advertising permitted by Section 651. (m) The violation of any of the provisions of law regulating the procurement, dispensing, or administration of dangerous drugs, as defined in Chapter 9 (commencing with Section 4000) or controlled substances, as defined in Division 10 (commencing with Section 11000) of the Health and Safety Code. (n) The violation of any of the provisions of this division. (o) The permitting of any person to operate dental radiographic equipment who has not met the requirements of Section 1656. (p) The clearly excessive prescribing or administering of drugs or treatment, or the clearly excessive use of diagnostic procedures, or the clearly excessive use of diagnostic or treatment facilities, as determined by the customary practice and standards of the dental profession. Any person who violates this subdivision is guilty of a misdemeanor and shall be punished by a fine of not less than one hundred dollars ($100) or more than six hundred dollars ($600), or by imprisonment for a term of not less than 60 days or more than 180 days, or by both a fine and imprisonment. (q) The use of threats or harassment against any patient or licensee for providing evidence in any possible or actual disciplinary action, or other legal action; or the discharge of an employee primarily based on the employee’s attempt to comply with the provisions of this chapter or to aid in the compliance. (r) Suspension or revocation of a license issued, or discipline imposed, by another state or territory on grounds that would be the basis of discipline in this state. (s) The alteration of a patient’s record with intent to deceive. (t) Unsanitary or unsafe office conditions, as determined by the customary practice and standards of the dental profession. (u) The abandonment of the patient by the licensee, without written notice to the patient that treatment is to be discontinued and before the patient has ample opportunity to secure the services of another dentist, registered dental hygienist, registered dental hygienist in alternative practice, or registered dental hygienist in extended functions and provided the health of the patient is not jeopardized. (v) The willful misrepresentation of facts relating to a disciplinary action to the patients of a disciplined licensee. (w) Use of fraud in the procurement of any license issued pursuant to this chapter. (x) Any action or conduct that would have warranted the denial of the license. (y) The aiding or abetting of a licensed dentist, dental assistant, registered dental assistant, registered dental assistant in extended functions, dental sedation assistant permitholder, orthodontic assistant permitholder, registered dental hygienist, registered dental hygienist in alternative practice, or registered dental hygienist in extended functions to practice dentistry in a negligent or incompetent manner. (z) (1) The failure to report to the board in writing within seven days any of the following: (A) the death of the licensee’s patient during the performance of any dental or dental hygiene procedure; (B) the discovery of the death of a patient whose death is related to a dental or dental hygiene procedure performed by the licensee; or (C) except for a scheduled hospitalization, the removal to a hospital or emergency center for medical treatment of any patient to whom oral conscious sedation, conscious sedation, or general anesthesia was administered, or any patient as a result of dental or dental hygiene treatment. With the exception of patients to whom oral conscious sedation, conscious sedation, or general anesthesia was administered, removal to a hospital or emergency center that is the normal or expected treatment for the underlying dental condition is not required to be reported. Upon receipt of a report pursuant to this subdivision the board may conduct an inspection of the dental office if the board finds that it is necessary. A dentist shall report to the board all deaths occurring in the licensee’s practice with a copy sent to the Dental Hygiene Board of California if the death was the result of treatment by a registered dental hygienist, registered dental hygienist in alternative practice, or registered dental hygienist in extended functions. A registered dental hygienist, registered dental hygienist in alternative practice, or registered dental hygienist in extended functions shall report to the Dental Hygiene Board of California all deaths occurring as the result of dental hygiene treatment, and a copy of the notification shall be sent to the board. (2) The report required by this subdivision shall be on a form or forms approved by the board. The form or forms approved by the board shall require the licensee to include, but not be limited to, the following information for cases in which patients received anesthesia: the date of the procedure; the patient’s age in years and months, weight, and sex; the patient’s American Society of Anesthesiologists (ASA) physical status; the patient’s primary diagnosis; the patient’s coexisting diagnoses; the procedures performed; the sedation setting; the medications used; the monitoring equipment used; the category of the provider responsible for sedation oversight; the category of the provider delivering sedation; the category of the provider monitoring the patient during sedation; whether the person supervising the sedation performed one or more of the procedures; the planned airway management; the planned depth of sedation; the complications that occurred; a description of what was unexpected about the airway management; whether there was transportation of the patient during sedation; the category of the provider conducting resuscitation measures; and the resuscitation equipment utilized. Disclosure of individually identifiable patient information shall be consistent with applicable law. A report required by this subdivision shall not be admissible in any action brought by a patient of the licensee providing the report. (3) For the purposes of paragraph (2), categories of provider are: General Dentist, Pediatric Dentist, Oral Surgeon, Dentist Anesthesiologist, Physician Anesthesiologist, Dental Assistant, Registered Dental Assistant, Dental Sedation Assistant, Registered Nurse, Certified Registered Nurse Anesthetist, or Other. (4) The form shall state that this information shall not be considered an admission of guilt, but is for educational, data, or investigative purposes. (5) The board may assess a penalty on any licensee who fails to report an instance of an adverse event as required by this subdivision. The licens [Text truncated for display. Full text available on Congress.gov.]