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S 2878Health Insurance

Businesses and Professions - Dentists and Dental Hygienists

This bill allows public health dental hygienists to bill private insurance companies for services provided in schools, clinics, and nursing homes.

Signed into law63 Yea0 Nay12 Not voting
Population
Affected
25
Email Legislator
Introduced Mar 4, 2026Committee Senate Health & Human Services

Plain-English Summary

This legislation amends the regulations regarding public health dental hygienists in Rhode Island. Specifically, it expands the billing capabilities of these professionals. Previously restricted primarily to Medicaid reimbursement, the bill allows public health dental hygienists, or the agencies and mobile programs they work for, to seek reimbursement from private insurance companies and other third-party payors. The bill maintains existing requirements for collaborative agreements with dentists or government agencies and ensures that patients are informed that these services do not replace a comprehensive dental examination by a dentist.

For younger readers

This law helps people who clean teeth, called dental hygienists, get paid for their work when they visit places like schools or nursing homes. Before, they could mostly only get paid by the government health plan. Now, they can also ask regular insurance companies to pay them. This helps them keep working in places outside of a regular dentist's office so more people can get their teeth cleaned. It also makes sure they still work with a dentist to help keep patients safe.

Who & Where It Applies

Impacted groups
Dental HygienistsDentistsNursing Home ResidentsInsurance CompaniesSchool Children
Impacted communities
All

Constitutional & Fiscal Check

None Likely

Estimated cost
None
Estimated revenue
None

Bill Analysis

Both viewpoints
For Progressives
  • Significantly increases access to dental care for vulnerable populations in nursing homes, schools, and community centers by making mobile clinics more financially sustainable.
  • Empowers dental hygienists, a workforce often comprised of women, by granting them greater professional autonomy and the ability to be reimbursed directly for their labor.
  • Strengthens the public health infrastructure by diversifying revenue streams for community health centers and mobile programs, reducing sole reliance on Medicaid.
  • Could potentially create a two-tiered healthcare system where low-income individuals only see hygienists in mobile settings while wealthier individuals see dentists in private practices.
  • Focuses on private insurance reimbursement rather than expanding a universal public dental benefit, maintaining reliance on the for-profit insurance industry.
  • May lead to fragmented care if communication between the mobile hygienist and a supervising dentist is not rigorously enforced, potentially delaying diagnosis of serious oral health issues.
For Conservatives
  • Promotes free-market competition by allowing hygienists to operate more independently, potentially lowering the overall cost of routine preventative care.
  • Encourages private sector solutions by shifting some cost burdens from state-funded Medicaid to private third-party insurers.
  • Reduces regulatory barriers for small business owners, such as independent mobile dental hygiene practitioners, allowing them to grow their businesses.
  • Undermines the traditional hierarchy of dental care by diminishing the oversight role of the dentist, potentially risking patient safety for the sake of efficiency.
  • Could lead to an increase in insurance premiums if the volume of billed claims rises significantly due to the expanded pool of eligible billers.
  • Expands the complexity of the healthcare bureaucracy by adding another layer of providers interacting with the insurance system.

Votes

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Full Bill Text

Changes to existing Rhode Island law · 2 additions · 1 deletion

It is enacted by the General Assembly as follows:

SECTION 1. Section 5-31.1-39 of the General Laws in Chapter 5-31.1 entitled "Dentists and Dental Hygienists" is hereby amended to read as follows: 5-31.1-39. Public health hygienists.

(a) Any public health dental hygienist, which for purposes of this chapter means any practicing registered dental hygienist who may perform dental-hygiene procedures in a public- health setting subject to conditions adopted by the Rhode Island board of examiners in dentistry, may perform in a public-health setting, without the immediate or direct supervision or direction of a dentist, any procedure or provide any service that is within the dental-hygiene scope of practice that has been authorized and adopted by the Rhode Island board of examiners in dentistry as a delegable procedure for a dental hygienist under general supervision in a private practice setting.

(b) Public-health settings shall, for purposes of this section, include, but are not limited to, residences of the homebound, schools, nursing home and long-term-care facilities, clinics, hospitals, medical facilities, community health centers licensed or certified by the department of health, mobile and portable dental-health programs licensed or certified by the department of health and operated by a local or state agency, head-start programs, and any other facilities or programs deemed appropriate by the department of health.

(c) Any public-health hygienist shall enter into a written, collaborative agreement with a local or state government agency or institution or with a licensed dentist who states that he or she shall be able to provide the appropriate level of communication and consultation with the dental hygienist to ensure patient health and safety prior to performing any procedure or providing any service under this section. The written, collaborative agreement will follow the appropriate guidelines as determined and established by the Rhode Island board of examiners in dentistry.

(d) Any public-health dental hygienist shall provide to the patient, or to the patient’s legal guardian, a consent form to be signed by the patient or legal guardian. The consent form shall be consistent with current department of health policies that describes services to be rendered and explains that services rendered are not a substitute for a dental examination by a dentist. The consent form shall also inform the patient or legal guardian that the patient should obtain a dental examination by a dentist within ninety (90) days after undergoing a procedure authorized pursuant to this section. The patient or legal guardian shall also obtain written referral to a dentist and an assessment of further dental needs.

(e) The public-health dental hygienist shall be directly reimbursed for services administered in a public-health setting by Medicaid or the state healthcare insurance program except as required by federal Medicaid law, but shall not and may seek reimbursement from any other insurance or third-party payor. A public-health dental hygienist shall not operate independently of a dentist, except for a dental hygienist working for a local or state government agency or institution or practicing in a mobile or portable prevention program licensed or certified by the department of health. In such cases, the local or state government agency or institution or mobile or portable prevention program licensed or certified by the department of health may seek reimbursement from any other third-party payor.

SECTION 2. This act shall take effect upon passage.