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2010 SESSION

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HB 1263 Dentists and oral surgeons; reimbursement for certain services.

Introduced by: R. Lee Ware, Jr. | all patrons    ...    notes | add to my profiles | history

SUMMARY AS PASSED HOUSE:

Dental plans; reimbursement for health care services. Prohibits a contract between a dental plan and a dentist or oral surgeon from establishing the fee or rate that the dentist or oral surgeon is required to accept for the provision of health care services, or from requiring that a dentist or oral surgeon accept the reimbursement paid by the dental plan as payment in full, unless the services are covered services under the dental plan. The measure applies to contracts entered into, amended, extended, or renewed on or after July 1, 2010. The State Corporation Commission does not have jurisdiction to adjudicate individual controversies arising out of this measure. SB 622 is identical.

SUMMARY AS INTRODUCED:

Dental plans; reimbursement for health care services.  Prohibits a contract for the provision of health care between a dental plan and a dentist or oral surgeon that establishes the fee or rate that the dentist or oral surgeon is required to accept for the provision of health care services, or from requiring that a dentist or oral surgeon accept the reimbursement paid by the dental plan as payment in full for health care services. These prohibitions do not apply to covered health care services that a dentist or oral surgeon has agreed to provide on behalf of the dental plan to its insured, subscribers, or enrollees with an expectation of receiving payment, other than copayments or deductibles, directly or indirectly from the dental plan. The measure applies to contracts entered into, amended, extended, or renewed on or after July 1, 2010.