82R2249 RWG-F
By: Carona S.B. No. 554
A BILL TO BE ENTITLED
AN ACT
relating to contracts between dentists and health maintenance
organizations or insurers.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter I, Chapter 843, Insurance Code, is
amended by adding Section 843.3115 to read as follows:
Sec. 843.3115. CONTRACTS WITH DENTISTS. A contract between
a health maintenance organization and a dentist may not limit the
fee the dentist may charge for a service for which an enrollee's
health care plan does not provide a benefit or reimbursement,
including a service that exceeds the annual or lifetime maximum
plan limit or that is provided during a waiting period.
SECTION 2. Subchapter E, Chapter 1451, Insurance Code, is
amended by adding Section 1451.2065 to read as follows:
Sec. 1451.2065. CONTRACTS WITH DENTISTS. A contract
between an insurer and a dentist may not limit the fee the dentist
may charge for a service for which a patient's employee benefit plan
or health insurance policy does not provide a benefit or
reimbursement, including a service that exceeds the annual or
lifetime maximum limit of the plan or policy or that is provided
during a waiting period.
SECTION 3. Sections 843.3115 and 1451.2065, Insurance Code,
as added by this Act, apply only to a contract entered into or
renewed on or after the effective date of this Act. A contract
entered into or renewed before the effective date of this Act is
governed by the law in effect immediately before the effective date
of this Act, and that law is continued in effect for that purpose.
SECTION 4. This Act takes effect September 1, 2011.