WA SB5351

Dental insurance plans cannot deny coverage for procedures solely because they were performed on the same day, though denials are still permitted for fraud prevention, unbundling, clinical appropriateness, medical necessity, or plan limitations.

Insurers may only pay dental providers via credit card if they notify providers of fees in advance, offer a fee-free alternative payment method, and provide clear instructions for selecting that alternative.

The Insurance Commissioner must contract with the William D. Ruckelshaus Center to convene stakeholders (dental associations, insurers, consumers) to address dental loss ratios and provider payment issues, with a final report due June 30, 2026.

Annual dental plan reporting requirements are amended to specify that submitted data must be based on Washington state data only and may not include data from other states.

Effective date is July 27, 2025; Section 6 (emergency clause) was vetoed by Governor Ferguson as unnecessary since implementation was already underway.