Insurance Carrier Fees Noncovered Dental Services

The bill prohibits a contract between a carrier and a dentist from requiring a dentist to provide services to a covered person at a fee set by, or subject to the approval of, the carrier unless:

• The services are covered services under the person's policy; and
• The carrier provides payment for the service under the person's policy in an amount that is reasonable and not nominal or de minimis.

The bill authorizes a dentist to charge a covered person for noncovered items or services in any amount determined by the dentist and agreed to by the patient if the amount is equal to, or less than, the usual and customary amount that the dentist charges individuals who are not enrolled for such items and services.

(Note: This summary applies to this bill as introduced.)