2021 -- H 5160

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LC000120

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2021

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A N   A C T

RELATING TO INSURANCE -- HEALTH CARE ACCESSIBILITY AND QUALITY

ASSURANCE ACT

     

     Introduced By: Representative David A. Bennett

     Date Introduced: January 25, 2021

     Referred To: House Health, Education & Welfare

     It is enacted by the General Assembly as follows:

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     SECTION 1. Section 27-18.8-4 of the General Laws in Chapter 27-18.8 entitled "Health

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Care Accessibility and Quality Assurance Act" is hereby amended to read as follows:

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     27-18.8-4. Contracts with providers for dental services.

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     No contract between a dental plan of a health care entity and a dentist for the provision of

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services to beneficiaries may require that a dentist provide services to its patients at a fee set by the

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health care entity unless said services are covered services under the applicable subscriber

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agreement. "Covered services," as used herein, means services reimbursable reimbursed, in whole

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or in part, under the applicable beneficiary agreement, subject to such contractual limitations on

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beneficiary benefits as may apply, including, for example, deductibles, waiting period, or frequency

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limitations.

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     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO INSURANCE -- HEALTH CARE ACCESSIBILITY AND QUALITY

ASSURANCE ACT

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     This act would redefine the term "covered services" as used to describe applicable

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subscriber agreements between a health care entity and a dentist.

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     This act would take effect upon passage.

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