The ADA Just Told Congress What PayorMap Already Built

On June 9, 2026, the ADA submitted a formal letter to the House Energy and Commerce Committee ahead of its hearing, "Lowering Health Care Costs for All Americans: Examining Policies to Increase Health Care Transparency." Signed by ADA President Richard Rosato, D.M.D., and Executive Director Nader Nadershahi, the letter laid out exactly what dental payer transparency should look like — and why hospital-style disclosure rules won't work for dental.

Read it and you're looking at a congressional record that validates the premise PayorMap was built on: dental payers control the data, not dental offices.

The ADA Validated What We Built

The core argument in the ADA letter is that dental benefit payers — not practices — control fee schedules, network leasing arrangements, adjudication rules, benefit design, annual maximums, frequency limitations, and every data point required to calculate what a patient actually owes. Practices are asked to price-post information they don't actually control.

That's the exact problem PayorMap was built to solve. Payers hold the data. We index it, normalize it, and make it searchable — so practices and DSOs can finally see what's happening on the other side of the ledger.

The letter specifically calls out network leasing arrangements as a transparency gap — one of the key payer-controlled data elements that prevents practices from accurately estimating patient costs. PayorMap's claim routing analysis already maps how claims get silently repriced through umbrella networks like Zelis, DenteMax, and Connection Dental. The ADA is asking Congress to fix a problem we're already solving.

The ADA also asked for payers to provide real-time, patient-specific coverage and cost-sharing information by CDT code — including maximum allowable fees, deductibles, coinsurance, annual maximums, frequency limitations, and expected plan payment. PayorMap has indexed over 500 million negotiated dental rates, searchable by CDT code, state, and payer. The infrastructure exists today. We're not waiting on Congress.

What the ADA Got Right

The letter draws a clear line between what hospitals deal with and what dental practices deal with. Hospital-style transparency rules — posting full fee schedules and negotiated rates — don't translate to dental. A raw fee schedule, stripped of benefit design context, annual maximums, frequency limitations, and network stacking arrangements, doesn't tell a patient what they owe. It just creates a number that looks precise and means nothing.

The ADA is right to push accountability onto payers, not practices. Dental offices don't set contracted rates. They accept them — often without knowing how those rates were arrived at, whether a leasing arrangement is in play, or whether the payer honoring the claim is even the one the practice contracted with.

The call for enhanced EOBs is long overdue. The letter asks Congress to require that EOBs include remaining annual maximums, frequency limitations, waiting periods, remaining deductibles, whether the service is covered, and the reason for any denial or partial payment. This is basic information that affects patient treatment planning and practice revenue — and it's routinely buried or unavailable. Practices lose revenue because they can't get clear answers on patient eligibility before the claim goes out. Patients get surprise bills because their EOBs are incomprehensible.

What's Not in the Letter — But Should Be

Network leasing gets a mention in the ADA letter, but it needs its own bill. The letter frames leasing as a transparency gap within a broader discussion of payer-controlled data. That undersells the scale of the problem. Silent PPO access and umbrella network repricing cost independent practices billions annually. Most providers don't know it's happening to them — not because the information is technically unavailable, but because understanding it requires cross-referencing payer contracts, network directories, and remittance data that no single source assembles.

The ADA also flagged DSO and private equity ownership transparency — supporting legislation that would require disclosure of who owns, controls, or manages the entity through which care is delivered. That's the right call. But the letter stops short of connecting ownership consolidation to payer contracting dynamics. As DSO consolidation accelerates, the gap between what large groups negotiate and what independent practices accept is widening. Transparency without benchmarking tools doesn't close that gap. Knowing your payer is also contracting with a DSO at rates 30% above yours is only actionable if you have the data to prove it.

Why This Matters Now

The bills under consideration — H.R. 5582 (Patients Deserve Price Tags Act), H.R. 9117 (the CHECK Act) — may or may not pass. That's Congress. But the conversation has shifted in a way that doesn't reverse. Dental payer transparency is no longer a niche complaint from practices frustrated with insurance. It's on the congressional record, backed by the largest dental association in the country, framed explicitly as a payer accountability issue.

Every practice owner and DSO operator should be asking the same question right now: what is my payer not telling me? What's my actual reimbursement rate versus what I contracted for? Is my claim being repriced through a network I never agreed to participate in? Is a competitor in my market being paid at materially different rates by the same payer?

Those answers exist. They're in the data. PayorMap surfaces them.

Sources: ADA News, June 11, 2026 · ADA Letter to House E&C Committee, June 9, 2026