Member's Page

J. M.

member image


by: Rep. Lozano,
J. M.

Measure Would Prevent Insurers and HMOs From Dictating Fees For Non-Covered Dental Services

Austin, TX— Today, the Texas House of Representatives passed HB 1776 by Rep. JM Lozano (Kingsville). HB 1776 prevents insurance companies and health maintenance organizations (HMOs) from setting fees on dental procedures for which they do not cover nor provide reimbursement.

"If insurers or employers want to offer these discounts on non-covered services, they should do so within a plan's benefits as covered services," said Rep. Lozano. "This proposed practice is unfair to dentists, as well as to patients. It would mean dentists would have to shift costs to their other patients. Not everyone has dental insurance."

Certain dental insurance companies are implementing contract provisions which dictate how much dentists may charge their patients even when the insurance company refuses to cover or pay for a particular dental procedure.

Currently, dentists have no negotiating power with insurance companies. Because of antitrust agreements, such as the Sherman Anti-trust Act, dentists are not allowed to group together as individuals or as an association to negotiate fair-treatment and fair contracts.

"A majority of our dentists in Texas are essentially small business owners. A third-party insurance group dictating fees-for-services which they do not cover nor provide any reimbursement for, prevents free-market competition between the small business owners," Rep. Lozano said.

H.B. 1776 received wide support by the Texas Dental Association which represents over 8,500 dentists in Texas, the American Dental Association which represents 150,000 dentists in the United States, the Texas Academy of General Dentistry, the Texas Academy of Pediatric Dentistry, and the Texas Association of Oral and Maxillofacial Surgeons.

Josh Reyna
(512) 463-0463

Contact Info


Capitol Address:
District Address:

Room 1W.4

P.O. Box 2910

Austin, TX 78768

(512) 463-0463

1512-A Wildcat Dr. Ste. 106

Portland, Texas 78374

(361) 643-0063