Dental Insurance Reform

Our Commitment to Fair Dental Insurance Practices

The Nebraska Dental Association works to ensure dental plans operate transparently, reimburse fairly, and support strong dentist–patient relationships. Over the years, we have championed legislation that reduces administrative burdens, improves accountability, and protects patient access to care. Below is an overview of the major areas where NDA has led or continues to lead reform efforts.

Key Legislative Priorities & Accomplishments

Dental Loss Ratio (DLR) and LB 639
Dental plans are not currently required to disclose how much of each premium dollar goes toward patient care versus administrative costs. NDA supports adopting a Dental Loss Ratio standard, which requires insurers to spend a minimum percentage of premiums directly on patient care or refund the difference.
LB 639, introduced in 2023, sought greater transparency from dental insurers by requiring reporting of claims costs, administrative expenses, and premiums collected. NDA continues to advocate for transparent, patient-centered use of premium dollars.

Overpayment Recovery
We support safeguards that prevent insurers from recouping overpayments from unrelated claims and require clear documentation when seeking repayment.

Credentialing Delays
Lengthy credentialing processes disrupt continuity of care. NDA advocates for temporary credentialing (such as during FMLA leave) so dentists can continue treating patients and be reimbursed.

Virtual Credit Card Fees
To protect providers from mandatory payment methods that include processing fees, NDA supported LB 954 (2020), which prohibits insurers from requiring credit-card-only claim payments.

Retroactive Denial of Prior Authorizations
We advocate for policies that require insurers to honor previously approved services, preventing financial surprises for patients and providers.

Network Leasing (Silent PPOs)
Through LB 954 (2020), NDA strengthened rules for disclosure, updating requirements so dentists can opt out of third-party network access and avoid unexpected contractual obligations.

Assignment of Benefits
We support legislation requiring all dental plans to honor a patient’s direction to send insurance payments directly to their treating dentist.

Non-Covered Services & Fee Caps
NDA helped pass LB 810 (2012) to prohibit insurers from capping fees on services they do not cover. We continue to monitor downgrading and other practices that shift costs unfairly.

Other Areas of Ongoing Advocacy
We continue to address issues such as downcoding, bundling, least-cost alternative clauses, coordination of benefits, and improvement of Explanation of Benefits clarity and accessibility.