SENATE DOCKET, NO. 675        FILED ON: 1/15/2019

SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 545

The Commonwealth of Massachusetts

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PRESENTED BY:

Harriette L. Chandler

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To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:

The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:

An Act relative to financial services contracts for dental benefits corporations.

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PETITION OF:

SENATE DOCKET, NO. 675        FILED ON: 1/15/2019

SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 545

The Commonwealth of Massachusetts

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In the One Hundred and Ninety-First General Court
(2019-2020)

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An Act relative to financial services contracts for dental benefits corporations.

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. Section 108B of Chapter 175 of the General Laws, as appearing in the 2016 Official Edition, is hereby amended by inserting at the end of said section the following sentence:- “No contract for the provision of healthcare services or benefits with a registered dentist shall require that such dentist provide dental services to a covered person at a particular fee unless said dental services are covered services. For the purposes of this section, “covered services” means dental services for which reimbursement is available or would be available but for the application of contractual limitations such as deductibles, copayments, coinsurance, waiting periods, annual or lifetime maximums, frequency limitations, age limitations, or alternative benefit payments. 

SECTION 2. Section 7 of Chapter 176B of the General Laws, as appearing in the 2016 Official Edition, is hereby amended by inserting after the second paragraph the following paragraph:- “No such agreement shall require that a dentist provide dental services to subscribers or their covered dependents at a particular fee unless said dental services are covered services. For the purposes of this section, “covered services” means dental services for which reimbursement is available or would be available but for the application of contractual limitations such as deductibles, copayments, coinsurance, waiting periods, annual or lifetime maximums, frequency limitations, age limitations, or alternative benefit payments.  

SECTION 3. Section 7 of Chapter 176E of the General Laws, as appearing in the 2016 Official Edition, is hereby amended by inserting after the second paragraph the following paragraph:- “No written agreement between a dental service corporation and a participating dentist shall require that the dentist provide dental services to subscribers or their covered dependents at a particular fee unless said dental services are covered services.  For the purposes of this section, “covered services” means dental services for which reimbursement is available or would be available but for the application of contractual limitations such as deductibles, copayments, coinsurance, waiting periods, annual or lifetime maximums, frequency limitations, age limitations, or alternative benefit payments.”

SECTION 4. Section 21 of Chapter 176G of the General Laws, as appearing in the 2016 Official Edition, is hereby amended by inserting after sub-section (d) the following sub-section:- “(e) No contract between a health maintenance organization and a participating provider who is a registered dentist shall require that such dentist provide dental services to a member at a particular fee unless said dental services are covered services. For the purposes of this section, “covered services” means dental services for which reimbursement is available or would be available but for the application of contractual limitations such as deductibles, copayments, coinsurance, waiting periods, annual or lifetime maximums, frequency limitations, age limitations, or alternative benefit payments.

SECTION 5. Section 2 of Chapter 176I of the General Laws, as appearing in the 2016 Official Edition, is hereby amended by inserting after the first paragraph the following paragraph:- “No preferred provider arrangement with a health care provider who is a registered dentist shall require that such dentist provide dental services to a covered person at a particular fee unless said dental services are covered services. For the purposes of this section, “covered services” means dental services for which reimbursement is available or would be available but for the application of contractual limitations such as deductibles, copayments, coinsurance, waiting periods, annual or lifetime maximums, frequency limitations, age limitations, or alternative benefit payments.