HF 2941

1st Engrossment - 86th Legislature (2009 - 2010) Posted on 03/08/2010 01:21pm

A bill for an act
relating to insurance; regulating dental insurance provider agreements; amending
Minnesota Statutes 2008, section 62Q.76, subdivision 1; proposing coding for
new law in Minnesota Statutes, chapter 62Q.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2008, section 62Q.76, subdivision 1, is amended to read:

Subdivision 1.

Applicability.

For purposes of sections 62Q.76 to deleted text begin 62Q.79 deleted text end new text begin 62Q.791 new text end ,
the terms deleted text begin defined in this section deleted text end new text begin contract, health care provider, dental plan, dental
organization, dentist, and enrollee new text end have the meanings given them new text begin in sections 62Q.733
and 62Q.76 new text end .

Sec. 2.

new text begin [62Q.791] CONTRACTS WITH DENTAL CARE PROVIDERS.
new text end

new text begin (a) Notwithstanding any other provision of law, no contract of any dental
organization licensed under chapter 62C for provision of dental care services may:
new text end

new text begin (1) require, directly or indirectly, that a dentist or health care provider provide dental
care services to its enrollees at a fee set by the dental organization, unless the services
provided are covered dental care services for enrollees under the dental plan or contract; or
new text end

new text begin (2) prohibit, directly or indirectly, the dentist or health care provider from offering or
providing dental care services that are not covered dental care services under the dental
plan or contract, on terms and conditions acceptable to the enrollee and the dentist or
health care provider. For purposes of this section, "covered dental care services" means
dental care services that are expressly covered under the dental plan or contract, including
dental care services that are subject to contractual limitations such as deductibles,
co-payments, annual maximums, and waiting periods.
new text end

new text begin (b) When making payment or otherwise adjudicating any claim for dental care
services provided to an enrollee, a dental organization or dental plan must clearly identify
on an explanation of benefits form or other form of claim resolution the amount, if any,
that is the enrollee's responsibility to pay to the enrollee's dentist or health care provider.
new text end

new text begin (c) This section does not apply to any contract for the provision of dental care
services under any public program sponsored or funded by the state or federal government.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2010.
new text end