CA SB1369

Health care service plans and health insurers must establish a non-fee-based default payment method for dental providers effective April 1, 2025, for all new, amended, or renewed contracts that provide direct payment or payment through a contracted vendor.

Dental providers must provide written authorization before being enrolled in any fee-based payment method, and health plans or vendors must disclose all fees, alternative payment methods, and the provider's right to opt out at any time.

Dental providers may opt out of fee-based payments and switch to non-fee-based methods at any time by providing written authorization, and their payment method choice applies to their entire practice and all covered products or services.

Health plans, insurers, or contracted vendors must provide claims and claim details with each payment and disclose any profit-sharing or fee arrangements between the vendor and the plan to the dental provider.

No state reimbursement is required because the bill creates violations under existing criminal law rather than imposing new mandates on local agencies.