Joint Letter to NCOIL re: Suggested Edits to Model Legislation on Dental Leasing and Payment

Dear Representative Keiser,

On behalf of a group of the below signed associations and companies, we respectfully submit comments and suggested edits to the model legislation on dental leasing and payment currently being considered by the National Council of Insurance Legislators (NCOIL). Our primary concern is the section of the model legislation that applies to electronic healthcare claim payments (Section E).

We fully support the idea that dentists and other providers should have full transparency as to the methods of payments available to them and any fees related to those methods. We also believe that providers are best served if they have choices between payment methods and the ability to freely choose the method that best fits their needs.

Our shared experience has found that, given a choice and knowing the associated fees, providers may choose virtual cards over other payment methods for the following reasons:

• Virtual cards give providers the ability to use existing payment card infrastructure to process virtual card transactions;
• There is no need to disclose banking information to health plans;
• There is no need to enroll with each health plan to receive payment;
• Virtual cards provide a reliable and secure way to receive payment; and
• Virtual cards provide guaranteed payment, with zero liability, in the event of fraud.

In the enclosed red-line strikeout of the model legislation, we suggest specific edits. Below, we explain why we think these edits would make the document a better piece of legislation.

We have also included an overview of the electronic healthcare payments environment.

Section E(I):

1. Suggest deleting the notice requirement in (3) for the following reasons:
   1. This provision could require the disclosure of confidential information in violation of contractual covenants and/or trade secrets and proprietary information of a payer otherwise protected under state law. Further, what a provider may be charged in interchange is unique to that provider. There is not “one credit card company” involved in the transaction. The card network is one participant, but there is also an issuing bank, a merchant acquirer and perhaps others involved in a single card transaction.
   2. This provision is not included in any existing federal or state law pertaining to healthcare claim payments. If the goal of the Model Law is to create uniformity across jurisdictions, this provision is inconsistent with nine other jurisdictions that have enacted statutes addressing virtual card payments on healthcare claims.
2. Suggest deleting the statement that lists offerings by a dentist’s agent for the following reason:
   
   

   Many parties that may assess a fee pursuant to an agreement with the provider may not be an “agent” as that term is generally understood under applicable law. In order to reflect the intent of the model legislation, this section should guarantee that any party that has made an agreement with the provider to provide any services associated with a payment should be required to disclose whether and what fees may apply. This broader guarantee is made in the first sentence of the section requiring the provider to consent to the fee.

   Technical edit: Under Definitions, if the statement in Section E(I) on Dentist Agent is removed, then “Dentist Agent” does not need to be defined.

We are willing to meet and discuss or provide testimony on our suggestions.

Thank you for your time.

American Bankers Association
Change Healthcare
ECHO Health Inc.
Electronic Payments Coalition
VPay, Inc.
Zelis