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HF 2916

as introduced - 92nd Legislature (2021 - 2022) Posted on 02/10/2022 03:46pm

KEY: stricken = removed, old language.
underscored = added, new language.

Bill Text Versions

Engrossments
Introduction Posted on 01/31/2022

Current Version - as introduced

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A bill for an act
relating to insurance; prohibiting the inclusion of certain terms in dental provider
agreements; requiring disclosures; amending Minnesota Statutes 2020, sections
62Q.76, by adding a subdivision; 62Q.78, subdivision 6, by adding a subdivision.

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

Section 1.

Minnesota Statutes 2020, section 62Q.76, is amended by adding a subdivision
to read:


new text begin Subd. 1a. new text end

new text begin Covered services. new text end

new text begin "Covered services" means dental care services for which
reimbursement: (1) is available under an enrollee's plan contract; or (2) would be available
but for the application of contractual limitations, including but not limited to deductibles,
co-payments, coinsurance, waiting periods, annual or lifetime maximums, frequency
limitations, alternative benefit payments, or any other limitation.
new text end

Sec. 2.

Minnesota Statutes 2020, section 62Q.78, subdivision 6, is amended to read:


Subd. 6.

Payment for covered services.

(a) No contract of any dental plan or dental
organization that covers any dental services or dental provider agreement with a dentist
may require, directly or indirectly, that a dentist provide services to an enrolled participant
at a fee set by, or at a fee subject to the approval of, the dental plan or dental organization
unless the dental services are covered services.

(b) A dental plan or dental organization or other person providing third-party
administrator services shall not make available any providers in its dentist network to a plan
that sets dental fees for any services except covered services.

deleted text begin (c) "Covered services" means dental care services for which a reimbursement is available
under an enrollee's plan contract, or for which a reimbursement would be available but for
the application of contractual limitations such as deductibles, co-payments, coinsurance,
waiting periods, annual or lifetime maximums, frequency limitations, alternative benefit
payments, or any other limitation.
deleted text end

Sec. 3.

Minnesota Statutes 2020, section 62Q.78, is amended by adding a subdivision to
read:


new text begin Subd. 7. new text end

new text begin Billing for covered services. new text end

new text begin A contract of any dental plan or dental organization
that covers any dental services or dental provider agreement must not prohibit a dentist from
billing and collecting payment from an enrollee for a covered service if the dentist:
new text end

new text begin (1) notifies the enrollee prior to performing the covered service that the dentist may not
be paid by the dental organization and the enrollee is responsible for payment of the covered
service;
new text end

new text begin (2) provides the enrollee with a written explanation of the benefits and material costs of
different suitable alternative options for the covered service, and discloses that the alternative
selected may not be paid for by the dental organization under the dental plan prior to the
performance of the covered service;
new text end

new text begin (3) obtains the enrollee's written consent to perform the covered service;
new text end

new text begin (4) provides a copy of the enrollee's written consent to the dental organization upon
request; and
new text end

new text begin (5) accepts as payment in full the amount the dentist would have accepted from the
dental organization under the dental plan for the covered service. A dentist must refund an
enrollee for any amount the enrollee paid in excess of this amount.
new text end

Sec. 4. new text begin EFFECTIVE DATE.
new text end

new text begin Sections 1 to 3 are effective January 1, 2023, and apply to dental plans and dental provider
agreements offered, issued, or renewed on or after that date.
new text end