In Chapters 319 and 345 of the Virginia Acts of Assembly, 2024 Session, the General Assembly directed the State Corporation Commission to convene a stakeholder work group to determine if revisions to § 38.2-3407.15 of the Code of Virginia (Code) are necessary “regarding ethics and fairness in dental carrier business practices and of health care providers of dental services." This section provides guiderails for how a dental carrier should handle claims from a dental provider. Specifically, it provides timeframes for reviewing and approving, defines “clean claim," and requires certain terms in a carrier-provider contract for services and reimbursement. Named stakeholders include dental carriers, representatives from the Virginia Dental Association (VDA) and Association of Dental Support Organizations, and other interested stakeholders. The work group must file its recommendations with the Chairs of the House Committee on Labor and Commerce and Senate Committee on Commerce and Labor by October 1, 2024.

In spring 2024, in advance of the work group meetings, dental providers and carriers began periodic meetings to discuss ways to enhance lines of communication, make the claims handling process more transparent, and learn how the legislative amendments to § 38.2-3407.15 of the Code1 might foster a better working relationship between them and improve a competitive dental provider marketplace. Both support these forums as a venue to educate each other about their needs and concerns, and both desire open avenues for collaboration. Many meetings outside the work group venue are expected.