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HOUSE DOCKET, NO.                 FILED ON: 2/1/2012

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 3916

 


The Commonwealth of Massachusetts
 

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In the Year Two Thousand Twelve

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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 2008 Official Edition, is hereby amended by inserting at the end of said section the following paragraph:- "No contract for the provision of healthcare services or benefits with a registered dentist may require that such dentist provide dental services to a covered person at a particular fee unless said dental services are services for which the company shall provide payment under the applicable group or individual policy of accident, sickness or health insurance and such fees shall be set in good faith and not be a nominal fee.  Notwithstanding the foregoing, such contract requirement shall be an optional requirement and upon the execution of any new or renewal agreement between a dentist and company, the dentist shall have the right to accept or reject such contract provision as a part of the contracting process.  Any election by a dentist to not accept such contract provision as a part of the overall contract offered by the company shall not be a basis for discrimination against such dentist or rejection of such dentist as a participating provider.   Moreover, no such requirement shall be enforced against a dentist outside of the provider agreement with the dentist through changes in policies and procedures of the company.” 

              Section 7 of chapter 176B of the General Laws, as appearing in the 2008 Official Edition, is hereby amended by inserting after the second paragraph the following paragraph:- "No such agreement may require that a dentist provide dental services to subscribers or their covered dependents at a particular fee unless said dental services are services for which the medical services corporation shall provide reimbursement under the applicable service agreement and such fees shall be set in good faith and not be a nominal fee.   Notwithstanding the foregoing, such contract requirement shall be an optional requirement and upon the execution of any new or renewal agreement between a dentist and a medical services corporation, the dentist shall have the right to accept or reject such contract provision as a part of the contracting process.  Any election by a dentist to not accept such contract provision as a part of the overall contract offered by the medical services corporation shall not be a basis for discrimination against such dentist or rejection of such dentist as a participating provider.   Moreover, no such requirement shall be enforced against a dentist outside of the provider agreement with the dentist through changes in policies and procedures of the medical services corporation.” 

              Section 7 of chapter 176E of the General Laws, as appearing in the 2008 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 may require that the dentist provide dental services to subscribers or their covered dependents at a particular fee unless said dental services are services for which the dental service corporation shall provide reimbursement under the applicable service agreement and such fees shall be set in good faith and not be a nominal fee.   Notwithstanding the foregoing, such contract requirement shall be an optional requirement and upon the execution of any new or renewal agreement between a dentist and a dental service corporation, the dentist shall have the right to accept or reject such contract provision as a part of the contracting process.  Any election by a dentist to not accept such contract provision as a part of the overall contract offered by the dental service corporation shall not be a basis for discrimination against such dentist or rejection of such dentist as a participating provider.   Moreover, no such requirement shall be enforced against a dentist outside of the provider agreement with the dentist through changes in policies and procedures of the dental service corporation.” 

              Section 21 of chapter 176G of the General Laws, as appearing in the 2008 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 may require that such dentist provide dental services to a member at a particular fee unless said dental services are services for which the health maintenance organization shall provide reimbursement under the applicable health maintenance contract and such fees shall be set in good faith and not be a nominal fee.  Notwithstanding the foregoing, such requirement shall be an optional requirement and upon the execution of any new or renewal agreement between a dentist and the health maintenance organization, the dentist shall have the right to accept or reject such contract provision as a part of the contracting process.  Any election by a dentist to not accept such contract provision as a part of the overall contract offered by the organization shall not be a basis for discrimination against such dentist or rejection of such dentist as a participating provider.   Moreover, no such requirement shall be enforced against a dentist outside of the provider agreement with the dentist through changes in policies and procedures of the health maintenance organization.” 

              Section 2 of chapter 1761 of the General Laws, as appearing in the 2008 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 may require that such dentist provide dental services to a covered person at a particular fee unless said dental services are services for which the organization shall provide reimbursement under the applicable preferred provider arrangement and such fees shall be set in good faith and not be a nominal fee.  Notwithstanding the foregoing, such requirement shall be an optional requirement and upon the execution of any new or renewal preferred provider arrangement contract between a dentist and the organization, the dentist shall have the right to accept or reject such contract provision as a part of the contracting process.  Any election by a dentist to not accept such contract provision as a part of the overall preferred provider arrangement contract offered by the organization shall not be a basis for discrimination against such dentist or rejection of such dentist as a participating provider.   Moreover, no such requirement shall be enforced against a dentist outside of the preferred provider contract with the dentist through changes in policies and procedures of the organization.

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