Session Laws

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:

Section 1 of chapter 560 of the acts of 1987 is hereby amended by striking out the seventh and eighth paragraphs and inserting in place thereof the following two paragraphs:-

The total adjustments shall be sufficient to generate, over a twelve month period, additional payments to participating dentists equal to the total dollar increase in medical malpractice insurance premium charges for the current year over the charges which were fixed and established for said insurance for the prior year, multiplied by the following fraction: (a) the numerator shall be the per cent of total revenues for dentists, which the dental service corporation's payments for services subject to limitations on charges and collections imposed by contractual agreement of such dental service corporation constitute, plus one-half of the per cent of total revenues for dentists, paid by health insurance under Title XVIII of the Social Security Act; and (b) the denominator shall be one hundred per cent minus the per cent of total revenues for dentists, paid by the dental service corporation under policies providing supplemental coverage to health insurance under Title XVIII of the Social Security Act, if any. In the event that medical malpractice insurance premium charges decrease, negative adjustments shall be made pursuant to the same formula.

The commissioner of insurance shall determine the method by which the dental service corporation shall disburse to the participating dentist the adjustments contemplated by this chapter and shall be authorized to approve disbursing methods which aggregate payments of procedure code adjustments over a period not to exceed one year. If consistent with the disbursement methodology approved by the commissioner, any participating dentist, when filing a request for payment based on a procedure code with said dental service corporation, shall be allowed to include the dollar amount of the total adjustment allocated for that procedure code; provided, however, that said dollar amount shall not be separately stated. Upon submission of such dollar amount by the participating dentist, the dental service corporation shall include all of the dollar amount in the amount calculated to be paid to the participating dentists for that procedure code. No change in medical malpractice insurance premium charges shall be approved by the commissioner of insurance until he has determined the percentage shares of total revenues for dentists paid by the dental service corporations and others as provided herein. The adjustment to payments by the dental service corporation shall take effect with the next regularly scheduled change in payments following the change in medical malpractice insurance premiums; provided, however, that said next regularly scheduled change in payments shall not be less than ninety days following the decision fixing and establishing total adjustments. The dental service corporation shall make available to participating dentists a list of the adjustments by the procedure code that have been made prior to the next regularly scheduled change in payments. The dental service corporation shall also provide said list to the division of insurance, which shall make available such list upon request.