Hard Work Brings Wins
Throughout the year, the MDS and our members advocate for oral health legislation in Massachusetts. We’re proud to share the successes we’ve achieved in recent years.
Learn about the status of legislation that will impact you, your dental practice, and the oral health of the residents of the Commonwealth. Questions? Contact advocacy@massdental.org.
Dentist Diversion Program
An Act establishing a dentist diversion program | H.300
Governor Maura Healey signed H.5143, An Act Relative to Treatments and Coverage for Substance Use Disorder and Recovery Coach Licensure (which included language from bill H.300) into law on December 2024. This landmark legislation includes provisions to establish a dental diversion program within the Bureau of Health Professionals Licensure (BHPL), which oversees both the Massachusetts Board of Registration in Dentistry (BORID) and the Unified Recovery and Monitoring Program (URAMP), a key initiative first introduced through House Bill 300.
Dental Hygienist Reciprocal Licensure
An Act relative to dental hygienist reciprocal licensure | H.4842 (formerly H.3880)
The Governor of Massachusetts signed this bill on January 10, 2025. In response to the growing shortage of hygienists, Representative Tackey Chan and MDS President Dr. Abe Abdul collaborated to craft legislation that expands the oral health workforce. This law provides a responsible and safe pathway for foreign-trained dentists to practice dental hygiene in the state of Massachusetts. It’s a solution that protects access to care, ensures practices are adequately staffed, and extends opportunity to immigrant communities who are integral to the fabric of our state.
PLEASE NOTE: Although the passage of these laws is a “win” for dentists and patients in Massachusetts, the work is not over. The approved bills instruct the State on what to do; however, the State is still working to promulgate the rules and regulations that will put the new laws into use.
A law does not take effect until this sometimes lengthy process has been completed. In the meantime, we kindly request that you refrain from contacting the Board of Registration in Dentistry (BORID) regarding these pending laws. BORID cannot provide any assistance until the final regulations are in place.
The MDS will closely monitor and keep members informed as the process progresses.
Dental Loss Ratio Regulation
In November 2022, Massachusetts became the first state in the nation to pass Dental Loss Ratio (DLR) legislation, also known as Medical Loss Ratio (MLR). This regulation requires that dental insurance companies spend at least 83% of patient premium dollars on patient care.
The Division of Insurance also conducted a special examination in 2023 to gain a deeper understanding of the dental insurance market in Massachusetts. The report from this examination summarizes dental coverage as of 2022 and compares it to the results of a prior examination, which presented information as of 2012.
Since the passage of the ballot initiative, the following steps have been taken.
- On April 4, 2024, the Division of Insurance (DOI) released the regulation to implement M.G.L. c. 176X, created under Chapter 287 of the Acts of 2022 (Question 2)
- The regulation was filed with the Massachusetts Secretary of State and officially published on April 12, 2024, making it law. Dental insurers were required to begin reporting in January 2025.
- Summer 2024, dental insurance companies provided the Massachusetts Department of Insurance (DOI) with their plan to meet the 83% ratio spending on patient care for 2025
- In summer 2025, dental insurers will have access to customer rebate forms and DLR reporting templates for 2026
- In summer 2025, dental insurers will submit to the DOI their plan to meet the 83% ratio for 2026 patient care.
- 2026 (month TBD), dental insurers will submit rebates and reporting forms to the DOI for 2025 patient care
We’re proud that the Massachusetts landslide victory created a wave of change across the country. The American Dental Association recently reported that twenty-three states have taken steps to implement a version of dental loss ratio regulation (DLR) since 2023. North Dakota has become the most recent state to pass DLR regulations, and many others are considering moving forward with similar legislation. Each one of these victories puts patient care at the forefront!
The effective implementation of the new, first-in-the-nation law, which provides critical consumer protections to dental patients, is a significant victory for advancing oral and community health in Massachusetts. The Massachusetts Dental Society remains immensely thankful to our partners and voters who advocated to ensure dental patient premium dollars are spent on patient care, ultimately leading to the ballot measure’s overwhelming approval by every city and town in the Commonwealth,” said Massachusetts Dental Society President Abe Abdul, DMD. “We also thank the author of the bill, Dr. Mouhab Rizkallah, as well as the Division of Insurance, for including key provisions like requiring an annual Dental Loss Ratio (DLR) analysis, protecting insurer accountability and transparency measures, and clarifying the DLR definition to include fraud recoveries. The Society and its members stand ready to support policymakers and patients alike in implementing and experiencing the protections and benefits afforded by the new law.
The Ballot Initiative
The Massachusetts Dental Society (MDS) lobbied for the Dental Loss Ratio (DLR) policy, formerly known as Medical Loss Ratio (MLR), for years. Through the perseverance and valiant efforts of a small group of dentists and patients, DLR dental reform appeared on the Massachusetts ballot as Question 2 in November 2022. Winning in a landslide victory, this important reform enhances accountability and transparency for dental insurers, prioritizing patient needs.
The MDS and the American Dental Association (ADA) together created the Massachusetts Dental Care Providers for Better Dental Benefits Committee. The committee informed and engaged voters on the campaign message of “Voting Yes on Question 2” by developing a website, promotional materials, advertisements, and other communication methods to inform Massachusetts voters on the issue. Grassroots efforts by MDS members, who reached out to voters, also contributed to the victory.
Note: An Act Relative to Transparency of Dental Benefits Corporations was sent to study in the 2021-2022 legislative session. This led the MDS Board of Trustees to support the MLR ballot initiative.
Regulatory Process
The Massachusetts Department of Insurance (DOI), responsible for creating regulations based on the ballot initiative, hosted several information sessions to solicit comments before drafting the regulations. The MDS submitted written responses and attended the following sessions.
- Section 1: Definitions, including dental loss ratios, held on January 18, 2023
- Section 2(a)–(c): Rate filing submissions and rebate calculation submissions—held on February 1, 2023
- Section 2(d)–(g): Rate filing reviews—help on February 15, 2023
- Section 3: Reporting annual comprehensive financial statements, held on March 1, 2023
- Additional Questions/Wrap-Up, held on March 15, 2023
The DOI then drafted the regulation based on the comments from the listening sessions and independently solicited feedback (e.g., an independent report from an actuary). The draft regulation was released to the public, and a meeting was held to gather input. In accordance with the process set forth by the DOI, the Massachusetts Dental Society submitted a formal response to the draft regulation and offered live comments at the meeting.
Upon reviewing all comments, the DOI finalized the regulation, which was passed into law in April 2024. Dental insurers are required to begin reporting in January 2025.