Minnesota Legislature
SF 1040
as introduced - 93rd Legislature (2023 - 2024) Posted on 02/02/2023 10:06am
Current Version - as introduced
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A bill for an act
relating to insurance; changing definition of covered services for dental care;
amending Minnesota Statutes 2022, section 62Q.78, subdivision 6.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2022, 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.
(c) "Covered services" means dental care services deleted text begin 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 limitationdeleted text end new text begin that are reimbursed in whole or in part under a dental
provider agreementnew text end .
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(d) Nothing in this section shall be construed as limiting the ability of a dental plan or
dental organization or other person providing third party administrator services to restrict
any of the following as they relate to covered services:
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(1) balance billing;
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(2) waiting periods;
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(3) frequency limitations;
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(4) deductibles; or
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(5) maximum annual benefits.
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