| 19 | 7 | | relating to licenses for the practice of dentistry, so as to authorize and regulate teledentistry2 |
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| 20 | 8 | | by licensed dentists in this state; to provide for definitions; to provide for exemptions and3 |
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| 21 | 9 | | conditions; to provide for authorized practices; to provide for a referred dentist; to provide4 |
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| 22 | 10 | | for ownership of documents; to provide for a limited number of dental hygienists to perform5 |
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| 23 | 11 | | teledentistry under certain conditions; to provide for rules and regulations; to amend Article 16 |
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| 24 | 12 | | of Chapter 24 of Title 33 of the Official Code of Georgia Annotated, relating to general7 |
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| 25 | 13 | | provisions of insurance, so as to allow for coverage of dental services provided through8 |
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| 26 | 14 | | teledentistry; to provide for related matters; to provide an effective date; to repeal conflicting9 |
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| 27 | 15 | | laws; and for other purposes.10 |
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| 28 | 16 | | BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:11 |
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| 29 | 17 | | SECTION 1.12 |
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| 30 | 18 | | Article 2 of Chapter 11 of Title 43 of the Official Code of Georgia Annotated, relating to13 |
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| 31 | 19 | | licenses for the practice of dentistry, is amended by adding a new Code section to read as14 |
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| 32 | 20 | | follows:15 |
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| 35 | 22 | | "43-11-54.16 |
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| 36 | 23 | | (a) As used in this Code section, the term:17 |
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| 37 | 24 | | (1) 'Authorizing dentist' means a dentist licensed by and in good standing with the board18 |
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| 38 | 25 | | and practicing in the State of Georgia.19 |
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| 39 | 26 | | (2) 'Dental hygienist' means a licensed dental hygienist in good standing with the board20 |
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| 40 | 27 | | who meets the requirements to perform the specific dental hygiene functions permitted21 |
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| 41 | 28 | | under general supervision under Code Section 43-11-74.22 |
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| 42 | 29 | | (3) 'Digital scan' means a computer generated replica of the hard and soft tissues of the23 |
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| 43 | 30 | | oral cavity created with digital technology and enhanced digital photography.24 |
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| 44 | 31 | | (4) 'Direct supervision' shall have the same meaning as set forth in Code Section25 |
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| 45 | 32 | | 43-l1-74.26 |
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| 46 | 33 | | (5) 'General supervision' shall have the same meaning as set forth in Code Section27 |
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| 47 | 34 | | 43-11-74.28 |
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| 48 | 35 | | (6) 'Referred dentist' means a dentist licensed by and in good standing with the board29 |
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| 49 | 36 | | practicing in this state to provide in-person dental treatment to patients receiving dental30 |
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| 50 | 37 | | care through a teledentistry interaction under this Code section.31 |
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| 51 | 38 | | (7) 'Store and forward technologies' means technologies that allow for the electronic32 |
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| 52 | 39 | | transmission of dental and health information, including images, photographs,33 |
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| 53 | 40 | | documents, and health histories, through a secure communication system.34 |
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| 54 | 41 | | (8) 'Synchronous, real-time communication' means a live, two-way interaction between35 |
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| 55 | 42 | | the authorizing dentist and a dental hygienist or patient permitted under this Code section36 |
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| 56 | 43 | | using audiovisual telecommunications technology but shall not constitute direct37 |
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| 57 | 44 | | supervision for the purposes of Code Section 43-l1-74 and the practice of dentistry in this38 |
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| 58 | 45 | | state.39 |
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| 59 | 46 | | (9) 'Teledentistry' means the delivery of dental care through the use of synchronous,40 |
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| 60 | 47 | | real-time communication in conjunction with and supported by store and forward41 |
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| 61 | 48 | | technologies under the general supervision of the authorizing dentist when dental care is42 |
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| 64 | 50 | | provided to a patient physically located at a site in this state that is different from the site43 |
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| 65 | 51 | | where the authorizing dentist is physically located. A teledentistry interaction shall not44 |
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| 66 | 52 | | constitute or be considered the equivalent of an in-person, clinical examination by a45 |
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| 67 | 53 | | licensed dentist.46 |
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| 68 | 54 | | (b) No licensed dentist in this state shall provide dental care through teledentistry except47 |
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| 69 | 55 | | under the conditions specified in this Code section.48 |
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| 70 | 56 | | (c) A licensed dentist who intends to provide dental care through teledentistry pursuant to49 |
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| 71 | 57 | | this Code section shall notify the board of such intent and provide written documentation50 |
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| 72 | 58 | | evidencing that such dentist has:51 |
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| 73 | 59 | | (1) A physical office for the provision of dental services in this state; and52 |
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| 74 | 60 | | (2) Established a referral relationship with a referred dentist who practices dentistry and53 |
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| 75 | 61 | | treats patients in a physical and operational dental office located in this state.54 |
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| 76 | 62 | | Such dentist shall provide other reasonably pertinent information as prescribed by the55 |
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| 77 | 63 | | board.56 |
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| 78 | 64 | | (d) Subject to the conditions specified in subsection (e) of this Code section, an57 |
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| 79 | 65 | | authorizing dentist shall only be allowed to:58 |
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| 80 | 66 | | (1) Authorize a dental hygienist to perform the specific dental hygiene functions59 |
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| 81 | 67 | | permitted under general supervision in accordance with the requirements of Code Section60 |
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| 82 | 68 | | 43-11-74, except as otherwise provided in paragraph (1) of subsection (e) of this Code61 |
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| 83 | 69 | | section;62 |
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| 84 | 70 | | (2) Prescribe a medication that is not a controlled substance for a patient receiving dental63 |
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| 85 | 71 | | care through a teledentistry interaction;64 |
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| 86 | 72 | | (3) Authorize the performance of digital scans by a dentist or dental hygienist;65 |
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| 87 | 73 | | (4) Authorize the use of store and forward technologies to transmit patient records,66 |
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| 88 | 74 | | images, digital scans, X-rays, and other relevant health information between the67 |
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| 89 | 75 | | authorizing dentist and a dental hygienist for the purposes of evaluating a patient's oral68 |
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| 90 | 76 | | health condition and authorizing the performance of dental care permitted under this69 |
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| 93 | 78 | | Code section. The authorizing dentist shall be the custodian of all patient records for the70 |
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| 94 | 79 | | purposes of this Code section unless the patient is treated by a referred dentist. In such71 |
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| 95 | 80 | | instance, the referred dentist shall be the custodian of the patient's records associated with72 |
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| 96 | 81 | | the dental care the referred dentist provides to the patient, and such referred dentist shall73 |
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| 97 | 82 | | furnish copies of these records to the authorizing dentist;74 |
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| 98 | 83 | | (5) Provide consultation to another provider regarding the patient's care; and75 |
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| 99 | 84 | | (6) Provide the following teledentistry services that are appropriately delivered without76 |
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| 100 | 85 | | an in-person clinical examination:77 |
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| 101 | 86 | | (A) Emergency evaluation;78 |
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| 102 | 87 | | (B) Rendering second opinions; and79 |
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| 103 | 88 | | (C) Assessment, diagnosis, consultation, treatment, and monitoring of a patient.80 |
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| 104 | 89 | | Teledentistry services described in this paragraph do not include orthodontics, delivering81 |
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| 105 | 90 | | of dental appliances, or the supervision of a dental hygienist.82 |
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| 106 | 91 | | (e) Authorizing and referring dentists as well as those acting under their supervision shall83 |
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| 107 | 92 | | be subject to the following conditions when providing dental care through teledentistry as84 |
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| 108 | 93 | | authorized in subsection (d) of this Code section:85 |
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| 109 | 94 | | (1) Teledentistry services shall be consistent with how dental treatment is provided in86 |
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| 110 | 95 | | person and shall adhere to the standards of appropriate patient care required in other87 |
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| 111 | 96 | | dental care settings, including, but not limited to, appropriate patient examination, the88 |
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| 112 | 97 | | taking and review of X-rays, and review of a patient's medical and dental history;89 |
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| 113 | 98 | | (2)(A) Initial consultations with new patients may be conducted via teledentistry,90 |
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| 114 | 99 | | provided that the authorizing dentist establishes a bona fide dentist-patient relationship91 |
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| 115 | 100 | | by reviewing the patient's medical and dental history and verifying the patient's identity92 |
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| 116 | 101 | | and physical location to ensure the patient is physically located in this state when dental93 |
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| 117 | 102 | | care is provided and shall obtain the requisite consent from a parent or guardian if the94 |
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| 118 | 103 | | patient is a minor.95 |
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| 121 | 105 | | (B) An in-person clinical examination shall be performed immediately prior to96 |
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| 122 | 106 | | providing or authorizing services or treatments to patients that are not reversible or that97 |
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| 123 | 107 | | otherwise result in increased risk to the patient. For ongoing dentist-patient98 |
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| 124 | 108 | | relationships, dentists shall strongly encourage patients to be seen in person at least99 |
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| 125 | 109 | | annually.100 |
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| 126 | 110 | | (3) The authorizing dentist shall prepare a written authorization, which shall be given to101 |
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| 127 | 111 | | the patient and included in the patient's record, providing the name and license number102 |
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| 128 | 112 | | of the authorizing dentist and the name and license number of the dental hygienist103 |
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| 129 | 113 | | treating the patient during the teledentistry interaction, as well as any other information104 |
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| 130 | 114 | | the authorizing dentist or board deems appropriate;105 |
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| 131 | 115 | | (4) Prior to first performing teledentistry services, and at least annually thereafter,106 |
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| 132 | 116 | | informed consent shall be obtained from the patient, or from the parent or guardian if the107 |
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| 133 | 117 | | patient is a minor, explaining the alternatives to and the capabilities and limitations of108 |
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| 134 | 118 | | teledentistry, which shall include a written statement advising that a teledentistry109 |
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| 135 | 119 | | interaction is not equivalent to an in-person clinical examination and that the authorizing110 |
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| 136 | 120 | | dentist shall not be physically present during the delivery of dental care. Such informed111 |
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| 137 | 121 | | consent shall also be documented and included in the patient's record;112 |
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| 138 | 122 | | (5) The authorizing dentist shall provide dental services through teledentistry only if113 |
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| 139 | 123 | | such dental services are appropriate for the patient, as determined by such authorizing114 |
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| 140 | 124 | | dentist;115 |
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| 141 | 125 | | (6)(A) The authorizing dentist shall provide the name, license number, office mailing116 |
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| 142 | 126 | | address, and office phone number of the referred dentist to the patient after each117 |
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| 143 | 127 | | teledentistry interaction.118 |
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| 144 | 128 | | (B) The referred dentist shall accept a referral to treat all dental emergencies and119 |
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| 145 | 129 | | provide all necessary dental care, as determined by and in consultation with the120 |
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| 146 | 130 | | authorizing dentist.121 |
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| 149 | 132 | | (7)(A) An authorizing dentist may only authorize up to four dental hygienists to122 |
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| 150 | 133 | | perform the functions permitted in subsection (d) of this Code section at any one time.123 |
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| 151 | 134 | | This requirement shall not apply to the performance of dental hygiene duties by124 |
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| 152 | 135 | | personnel of the Department of Public Health or county boards of health.125 |
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| 153 | 136 | | (B) A dental hygienist performing the functions permitted in subsection (d) of this126 |
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| 154 | 137 | | Code section via teledentistry shall have at least two years of experience in the practice127 |
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| 155 | 138 | | of dental hygiene, shall be in compliance with continuing education requirements128 |
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| 156 | 139 | | pursuant to Code Section 43-11-73.1 and cardiopulmonary resuscitation certification129 |
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| 157 | 140 | | requirements contained in Code Section 43-11-73, and shall be licensed in good130 |
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| 158 | 141 | | standing.131 |
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| 159 | 142 | | (C) A dental hygienist practicing under general supervision via teledentistry pursuant132 |
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| 160 | 143 | | to this Code section shall maintain professional liability insurance in accordance with133 |
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| 161 | 144 | | board rules and regulations; provided, however, that this subparagraph shall not apply134 |
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| 162 | 145 | | to an entity covered under sovereign immunity;135 |
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| 163 | 146 | | (8) No authorizing dentist or dental hygienist shall attempt to waive liability for136 |
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| 164 | 147 | | teledentistry services in advance of delivering such services, and no authorizing dentist137 |
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| 165 | 148 | | or dental hygienist shall attempt to prevent a patient from filing any complaint with any138 |
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| 166 | 149 | | governmental agency or authority relating to the provision of dental care through139 |
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| 167 | 150 | | teledentistry; and140 |
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| 168 | 151 | | (9) The authorizing dentist shall ensure that the use of teledentistry complies with the141 |
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| 169 | 152 | | privacy and security requirements of the federal Health Insurance Portability and142 |
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| 170 | 153 | | Accountability Act of 1996, in effect on January 1, 2025, as well as those of Chapter 33143 |
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| 171 | 154 | | of Title 31.144 |
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| 172 | 155 | | (f) Nothing in this Code section shall be construed to:145 |
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| 173 | 156 | | (1) Require a licensed dentist in this state to practice teledentistry;146 |
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| 174 | 157 | | (2) Require a licensed dentist to authorize a dental hygienist to perform the functions147 |
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| 175 | 158 | | permitted in this Code section via teledentistry;148 |
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| 178 | 160 | | (3) Require a school or facility receiving dental hygiene services provided pursuant to149 |
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| 179 | 161 | | subsection (h) or (i) of Code Section 43-ll-74 to purchase any equipment to provide150 |
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| 180 | 162 | | dental care through teledentistry; or151 |
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| 181 | 163 | | (4) Expand the scope of practice for dental hygienists or establish independent dental152 |
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| 182 | 164 | | hygiene practice.153 |
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| 183 | 165 | | (g) The board shall promulgate rules and regulations that are reasonably necessary to154 |
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| 184 | 166 | | implement the provisions of this Code section."155 |
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| 185 | 167 | | SECTION 2.156 |
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| 186 | 168 | | Article 1 of Chapter 24 of Title 33 of the Official Code of Georgia Annotated, relating to157 |
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| 187 | 169 | | general provisions of insurance, is amended by revising Code Section 33-24-59.15 as158 |
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| 188 | 170 | | follows: 159 |
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| 189 | 171 | | "33-24-59.15.160 |
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| 190 | 172 | | (a) As used in this Code section:161 |
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| 191 | 173 | | (1) 'Care management organization' shall have the same meaning as set forth in Code162 |
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| 192 | 174 | | Section 33-21A-2.163 |
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| 193 | 175 | | (1)(2) 'Covered dental services' means dental care services for which a reimbursement164 |
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| 194 | 176 | | is available under a covered person's dental benefit plan, or for which a reimbursement165 |
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| 195 | 177 | | would be available but for the application of contractual limitations such as deductibles,166 |
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| 196 | 178 | | copayments, coinsurance, waiting periods, annual or lifetime maximums, frequency167 |
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| 197 | 179 | | limitations, alternative benefit payments, or any other limitation.168 |
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| 198 | 180 | | (2)(3) 'Covered person' means any subscriber, enrollee, member, beneficiary, or169 |
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| 199 | 181 | | participant, or his or her dependent, for whom benefits are payable when that covered170 |
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| 200 | 182 | | person receives dental care services rendered or authorized by a dentist licensed under171 |
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| 201 | 183 | | Chapter 11 of Title 43.172 |
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| 202 | 184 | | (3)(4) 'Dental benefit plan' means any individual or group plan, policy, contract, or173 |
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| 203 | 185 | | subscription agreement which includes or is for dental care services that is issued,174 |
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| 206 | 187 | | delivered, issued for delivery, or renewed in this state whether by a health care healthcare175 |
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| 207 | 188 | | insurer, health maintenance organization, preferred provider organization, accident and176 |
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| 208 | 189 | | sickness insurer, fraternal benefit society, health care healthcare plan, or any other person,177 |
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| 209 | 190 | | firm, corporation, joint venture, or other similar business entity that pays for, purchases,178 |
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| 210 | 191 | | or furnishes dental care services to patients, insureds, beneficiaries, or covered179 |
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| 211 | 192 | | dependents in this state.180 |
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| 212 | 193 | | (4)(5) 'Dental insurer' means any person, firm, corporation, joint venture, or other similar181 |
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| 213 | 194 | | business entity that offers dental benefit plans in consideration of periodic payments.182 |
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| 214 | 195 | | (b) No contract between a dental insurer and a dentist shall require a dentist to accept an183 |
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| 215 | 196 | | amount set by the dental insurer as payment for dental care services that are not covered184 |
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| 216 | 197 | | dental services under the covered person's dental benefit plan.185 |
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| 217 | 198 | | (c) A dental insurer or other person or entity providing third-party administrator services186 |
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| 218 | 199 | | shall not make available any providers in its dentist network to a plan that sets dental fees187 |
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| 219 | 200 | | for any services except covered services.188 |
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| 220 | 201 | | (d) A dental insurer shall not draft, publish, disseminate, or circulate explanation of benefit189 |
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| 221 | 202 | | forms that include language which directly or indirectly implies that a dentist may or190 |
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| 222 | 203 | | should extend discounts to patients for noncovered dental services. Statements by a dental191 |
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| 223 | 204 | | insurer which are prohibited by this Code section include but are not limited to, 'Our192 |
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| 224 | 205 | | members value the services you provide and we encourage you to continue extending the193 |
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| 225 | 206 | | discount on noncovered services.194 |
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| 226 | 207 | | (e) Any dental benefit plan issued, amended, or renewed on or after January 1, 2026,195 |
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| 227 | 208 | | between a dental insurer, contracted vendor thereof, or a care management organization196 |
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| 228 | 209 | | and a healthcare provider for the provision of healthcare services to a plan enrollee may197 |
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| 229 | 210 | | provide coverage for the cost of dental care provided through teledentistry as directed198 |
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| 230 | 211 | | through regulations promulgated by the Commissioner.199 |
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| 231 | 212 | | (f) A dental insurer, contracted vendor thereof, or care management organization shall not:200 |
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