25 LC 46 1179S
The House Committee on Health offers the following substitute to HB 567:
A BILL TO BE ENTITLED
AN ACT
To amend Article 2 of Chapter 11 of Title 43 of the Official Code of Georgia Annotated,1
relating to licenses for the practice of dentistry, so as to authorize and regulate teledentistry2
by licensed dentists in this state; to provide for definitions; to provide for exemptions and3
conditions; to provide for authorized practices; to provide for a referred dentist; to provide4
for ownership of documents; to provide for a limited number of dental hygienists to perform5
teledentistry under certain conditions; to provide for rules and regulations; to amend Article 16
of Chapter 24 of Title 33 of the Official Code of Georgia Annotated, relating to general7
provisions of insurance, so as to allow for coverage of dental services provided through8
teledentistry; to provide for related matters; to provide an effective date; to repeal conflicting9
laws; and for other purposes.10
BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:11
SECTION 1.12
Article 2 of Chapter 11 of Title 43 of the Official Code of Georgia Annotated, relating to13
licenses for the practice of dentistry, is amended by adding a new Code section to read as14
follows:15
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"43-11-54.16
(a) As used in this Code section, the term:17
(1) 'Authorizing dentist' means a dentist licensed by and in good standing with the board18
and practicing in the State of Georgia.19
(2) 'Dental hygienist' means a licensed dental hygienist in good standing with the board20
who meets the requirements to perform the specific dental hygiene functions permitted21
under general supervision under Code Section 43-11-74.22
(3) 'Digital scan' means a computer generated replica of the hard and soft tissues of the23
oral cavity created with digital technology and enhanced digital photography.24
(4) 'Direct supervision' shall have the same meaning as set forth in Code Section25
43-l1-74.26
(5) 'General supervision' shall have the same meaning as set forth in Code Section27
43-11-74.28
(6) 'Referred dentist' means a dentist licensed by and in good standing with the board29
practicing in this state to provide in-person dental treatment to patients receiving dental30
care through a teledentistry interaction under this Code section.31
(7) 'Store and forward technologies' means technologies that allow for the electronic32
transmission of dental and health information, including images, photographs,33
documents, and health histories, through a secure communication system.34
(8) 'Synchronous, real-time communication' means a live, two-way interaction between35
the authorizing dentist and a dental hygienist or patient permitted under this Code section36
using audiovisual telecommunications technology but shall not constitute direct37
supervision for the purposes of Code Section 43-l1-74 and the practice of dentistry in this38
state.39
(9) 'Teledentistry' means the delivery of dental care through the use of synchronous,40
real-time communication in conjunction with and supported by store and forward41
technologies under the general supervision of the authorizing dentist when dental care is42
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provided to a patient physically located at a site in this state that is different from the site43
where the authorizing dentist is physically located. A teledentistry interaction shall not44
constitute or be considered the equivalent of an in-person, clinical examination by a45
licensed dentist.46
(b) No licensed dentist in this state shall provide dental care through teledentistry except47
under the conditions specified in this Code section.48
(c) A licensed dentist who intends to provide dental care through teledentistry pursuant to49
this Code section shall notify the board of such intent and provide written documentation50
evidencing that such dentist has:51
(1) A physical office for the provision of dental services in this state; and52
(2) Established a referral relationship with a referred dentist who practices dentistry and53
treats patients in a physical and operational dental office located in this state.54
Such dentist shall provide any other pertinent information as prescribed by the board.55
(d) Subject to the conditions specified in subsection (e) of this Code section, an56
authorizing dentist shall only be allowed to:57
(1) Authorize a dental hygienist to perform the specific dental hygiene functions58
permitted under general supervision in accordance with the requirements of Code Section59
43-11-74, except as otherwise provided in paragraph (1) of subsection (e) of this Code60
section;61
(2) Prescribe a medication that is not a controlled substance for a patient receiving dental62
care through a teledentistry interaction;63
(3) Authorize the performance of digital scans by a dentist or dental hygienist;64
(4) Authorize the use of store and forward technologies to transmit patient records,65
images, digital scans, X-rays, and other relevant health information between the66
authorizing dentist and a dental hygienist for the purposes of evaluating a patient's oral67
health condition and authorizing the performance of dental care permitted under this68
Code section. The authorizing dentist shall be the custodian of all patient records for the69
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purposes of this Code section unless the patient is treated by a referred dentist. In such70
instance, the referred dentist shall be the custodian of the patient's records associated with71
the dental care the referred dentist provides to the patient, and such referred dentist shall72
furnish copies of these records to the authorizing dentist;73
(5) Provide consultation to another provider regarding the patient's care; and74
(6) Provide the following teledentistry services that are appropriately delivered without75
an in-person clinical examination:76
(A) Emergency evaluation;77
(B) Rendering second options; and78
(C) Assessment, diagnosis, consultation, treatment, and monitoring of a patient.79
Teledentistry services described in this paragraph do not include orthodontics, delivering80
of dental appliances, or the supervision of a dental hygienist.81
(e) Authorizing and referring dentists as well as those acting under their supervision shall82
be subject to the following conditions when providing dental care through teledentistry as83
authorized in subsection (d) of this Code section:84
(1) Teledentistry services shall be consistent with how dental treatment is provided in85
person and shall adhere to the standards of appropriate patient care required in other86
dental care settings, including, but not limited to, appropriate patient examination, the87
taking and review of X-rays, and review of a patient's medical and dental history;88
(2)(A) Initial consultations with new patients may be conducted via teledentistry,89
provided that the authorizing dentist establishes a bona fide dentist-patient relationship90
by reviewing the patient's medical and dental history and verifying the patient's identity91
and physical location to ensure the patient is physically located in this state when dental92
care is provided and shall obtain the requisite consent from a parent or guardian if the93
patient is a minor.94
(B) An in-person clinical examination shall be performed immediately prior to95
providing or authorizing services or treatments to patients that are not reversible or that96
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otherwise result in increased risk to the patient as set forth in regulations by the board. 97
For ongoing dentist-patient relationships, dentists shall strongly encourage patients to98
be seen in person at least annually.99
(3) The authorizing dentist shall prepare a written authorization, which shall be given to100
the patient and included in the patient's record, providing the name and license number101
of the authorizing dentist and the name and license number of the dental hygienist102
treating the patient during the teledentistry interaction, as well as any other information103
the authorizing dentist or board deems appropriate;104
(4) Prior to each teledentistry interaction, informed consent shall be obtained from the105
patient, or from the parent or guardian if the patient is a minor, explaining the alternatives106
to and the capabilities and limitations of teledentistry, which shall include a written107
statement advising that a teledentistry interaction is not equivalent to an in-person clinical108
examination and that the authorizing dentist shall not be physically present during the109
delivery of dental care. Such informed consent shall also be documented and included110
in the patient's record;111
(5) The authorizing dentist shall provide dental services through teledentistry only if112
such dental services are appropriate for the patient, as determined by such authorizing113
dentist;114
(6)(A) The authorizing dentist shall provide the name, license number, office mailing115
address, and office phone number of the referred dentist to the patient after each116
teledentistry interaction.117
(B) The referred dentist shall accept a referral to treat all dental emergencies and118
provide all necessary dental care, as determined by and in consultation with the119
authorizing dentist.120
(7)(A) An authorizing dentist may only authorize up to four dental hygienists to121
perform the functions permitted in subsection (d) of this Code section at any one time.122
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(B) A dental hygienist performing the functions permitted in subsection (d) of this123
Code section via teledentistry shall have at least two years of experience in the practice124
of dental hygiene, shall be in compliance with continuing education requirements125
pursuant to Code Section 43-11-73.1 and cardiopulmonary resuscitation certification126
requirements contained in Code Section 43-11-73, and shall be licensed in good127
standing.128
(C) A dental hygienist practicing under general supervision via teledentistry pursuant129
to this Code section shall maintain professional liability insurance in accordance with130
board rules and regulations; provided, however, that this subparagraph shall not apply131
to an entity covered under sovereign immunity;132
(8) No authorizing dentist or dental hygienist shall attempt to waive liability for133
teledentistry services in advance of delivering such services, and no authorizing dentist134
or dental hygienist shall attempt to prevent a patient from filing any complaint with any135
governmental agency or authority relating to the provision of dental care through136
teledentistry; and137
(9) The authorizing dentist shall ensure that the use of teledentistry complies with the138
privacy and security requirements of the federal Health Insurance Portability and139
Accountability Act of 1996, in effect on January 1, 2025, as well as those of Chapter 33140
of Title 31.141
(f) Nothing in this Code section shall be construed to:142
(1) Require a licensed dentist in this state to practice teledentistry;143
(2) Require a licensed dentist to authorize a dental hygienist to perform the functions144
permitted in this Code section via teledentistry;145
(3) Require a school or facility receiving dental hygiene services provided pursuant to146
subsection (h) or (i) of Code Section 43-ll-74 to purchase any equipment to provide147
dental care through teledentistry; or148
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(4) Expand the scope of practice for dental hygienists or establish independent dental149
hygiene practice.150
(g) The board shall promulgate rules and regulations that are reasonably necessary to151
implement the provisions of this Code section."152
SECTION 2.153
Article 1 of Chapter 24 of Title 33 of the Official Code of Georgia Annotated, relating to154
general provisions of insurance, is amended by revising Code Section 33-24-59.15 as155
follows: 156
"33-24-59.15.157
(a) As used in this Code section:158
(1) 'Care management organization' shall have the same meaning as set forth in Code159
Section 33-21A-2.160
(1)(2) 'Covered dental services' means dental care services for which a reimbursement161
is available under a covered person's dental benefit plan, or for which a reimbursement162
would be available but for the application of contractual limitations such as deductibles,163
copayments, coinsurance, waiting periods, annual or lifetime maximums, frequency164
limitations, alternative benefit payments, or any other limitation.165
(2)(3) 'Covered person' means any subscriber, enrollee, member, beneficiary, or166
participant, or his or her dependent, for whom benefits are payable when that covered167
person receives dental care services rendered or authorized by a dentist licensed under168
Chapter 11 of Title 43.169
(3)(4) 'Dental benefit plan' means any individual or group plan, policy, contract, or170
subscription agreement which includes or is for dental care services that is issued,171
delivered, issued for delivery, or renewed in this state whether by a health care healthcare172
insurer, health maintenance organization, preferred provider organization, accident and173
sickness insurer, fraternal benefit society, health care healthcare plan, or any other person,174
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firm, corporation, joint venture, or other similar business entity that pays for, purchases,175
or furnishes dental care services to patients, insureds, beneficiaries, or covered176
dependents in this state.177
(4)(5) 'Dental insurer' means any person, firm, corporation, joint venture, or other similar178
business entity that offers dental benefit plans in consideration of periodic payments.179
(b) No contract between a dental insurer and a dentist shall require a dentist to accept an180
amount set by the dental insurer as payment for dental care services that are not covered181
dental services under the covered person's dental benefit plan.182
(c) A dental insurer or other person or entity providing third-party administrator services183
shall not make available any providers in its dentist network to a plan that sets dental fees184
for any services except covered services.185
(d) A dental insurer shall not draft, publish, disseminate, or circulate explanation of benefit186
forms that include language which directly or indirectly implies that a dentist may or187
should extend discounts to patients for noncovered dental services. Statements by a dental188
insurer which are prohibited by this Code section include but are not limited to, 'Our189
members value the services you provide and we encourage you to continue extending the190
discount on noncovered services.191
(e) Any dental benefit plan issued, amended, or renewed on or after January 1, 2026,192
between a dental insurer, contracted vendor thereof, or a care management organization193
and a healthcare provider for the provision of healthcare services to a plan enrollee may194
provide coverage for the cost of dental care provided through teledentistry as directed195
through regulations promulgated by the Commissioner.196
(f) A dental insurer, contracted vendor thereof, or care management organization shall not:197
(1) Exclude a service appropriately provided through teledentistry from coverage solely198
because the service is provided through teledentistry and is not provided through199
in-person consultation or contact between an authorizing dentist and a patient; or200
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(2) Require its insureds to receive dental care through teledentistry in lieu of an201
in-person, clinical examination."202
SECTION 3.203
This Act shall become effective on January 1, 2026.204
SECTION 4.205
All laws and parts of laws in conflict with this Act are repealed.206
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