DLR: One Part of Dental Insurance Reforms MDA Seeks
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DA fully recognizes the challenges patients and dentists continue to face with dental insurance practices, particularly for out-of-network care. We are seeing a growing number of dentists choose to move out of network, often due to insurer practices such as delayed or inconsistent payments.
While MDA’s recent legislative focus has included broader systemic reforms such as Dental Loss Ratio (DLR) legislation — aimed at improving transparency and ensuring pre- mium dollars are directed toward patient care — issues related to assignment of benefi ts, timely payment, patient choice and insurer conduct remain active and ongoing areas of concern.
In coordination with the ADA, MDA is also assessing approaches used in other states that have proven eff ective in addressing these challenges.
PATIENT TOOLKIT CONTENTS // Enclosed are three easel-back posters to place in high- visibility areas, such as the Waiting Room, Checkout Area, Financial Consult Room and/or
Operatories. Each features a large QR code linking patients to the website where they can take action. Through a simple online form, they can send a pre-written message, in less than 60 seconds, to their Missouri lawmakers to support a DLR law. The website also includes a overview video and simple DLR FAQs, materials to help explain what a DLR law is/will do.
MDA provides resources and guidance on these topics through our Dental Insurance Resources page (
modental.org/dir) and will continue to evaluate legislative, regulatory and enforcement-based options to support Missouri dentists and protect patient access to care as implementation of recent reforms moves forward.
We appreciate your advocacy on behalf of patient autonomy and access to care, and we welcome continued engagement on these important dental insurance issues.
ADDRESSING OPPOSITION // The points below refl ect common opposition arguments related to a Dental Loss Ratio. While patients are unlikely to raise these issues, dentists may encounter them when speaking with legislators. The MDA will ensure Dental Day participants are prepared to both present our legislation and respond to opposition.
• DLR IS JUST MORE GOVERNMENT REGULATION // DLR is a modest, proven reform focused on transparency and patient protection. Effi cient insurers that prioritize care are not disadvantaged.
• INSURERS WILL LEAVE THE STATE // Similar concerns were raised about medical loss ratios under the ACA, yet widespread insurer exits did not occur. Well-run plans adapt.
• DLR WILL INCREASE PREMIUMS // DLR helps patients and employers better understand the value of coverage and includes regulatory oversight of premium increases.
• DLR IS ABOUT DENTISTS’ PROFITS // DLR is about access to care. When insurance fails to deliver value, patients delay or forgo treatment — harming both individual and public health.
ISSUE 4 | WINTER 2025 | focus 17
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