IA SF470

Dental carriers cannot deny claims for dental care services that received prior authorization, and must reimburse providers at the contracted rate for authorized services

Prior authorization protections include exceptions for situations such as benefit limitations reached after authorization, fraudulent claims, patient ineligibility, or when documentation fails to support the authorized service

Dental carriers must disclose to providers through online portals when a patient's dental care service plan is state-regulated, and must include "state-regulated" on identification cards issued on or after July 1, 2025

Dental carriers must provide written notice of overpayments to providers within 365 calendar days and establish appeal procedures allowing providers at least 90 days to contest overpayment recovery requests

Contractual waivers of these requirements are prohibited and declared null and void; the Commissioner of Insurance may adopt administrative rules to implement these provisions