Bill Text: IN SB0303 | 2012 | Regular Session | Amended


Bill Title: Dental benefits.

Spectrum: Partisan Bill (Republican 2-0)

Status: (Engrossed - Dead) 2012-02-09 - First reading: referred to Committee on Insurance [SB0303 Detail]

Download: Indiana-2012-SB0303-Amended.html


Reprinted

January 31, 2012





SENATE BILL No. 303

_____


DIGEST OF SB 303 (Updated January 30, 2012 5:12 pm - DI 84)



Citations Affected: IC 27-8; IC 27-13.

Synopsis: Dental benefits. Prohibits dental insurers and health maintenance organizations from requiring dentists to accept certain payments.

Effective: July 1, 2012.





Becker, Gard




    January 5, 2012, read first time and referred to Committee on Health and Provider Services.
    January 26, 2012, amended, reported favorably _ Do Pass.
    January 30, 2012, read second time, amended, ordered engrossed.





Reprinted

January 31, 2012

Second Regular Session 117th General Assembly (2012)


PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana Constitution) is being amended, the text of the existing provision will appear in this style type, additions will appear in this style type, and deletions will appear in this style type.
Additions: Whenever a new statutory provision is being enacted (or a new constitutional provision adopted), the text of the new provision will appear in this style type. Also, the word NEW will appear in that style type in the introductory clause of each SECTION that adds a new provision to the Indiana Code or the Indiana Constitution.
Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts between statutes enacted by the 2011 Regular Session of the General Assembly.

SENATE BILL No. 303



    A BILL FOR AN ACT to amend the Indiana Code concerning insurance.

Be it enacted by the General Assembly of the State of Indiana:

SOURCE: IC 27-8-11-4.7; (12)SB0303.2.1. -->     SECTION 1. IC 27-8-11-4.7 IS ADDED TO THE INDIANA CODE AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2012]: Sec. 4.7. (a) As used in this section, "covered services" means health care services for which any reimbursement is available under an insured's policy, regardless of whether the actual reimbursement is contractually limited by a deductible, copayment, coinsurance, waiting period, annual or lifetime maximum, frequency limitation, alternative benefit payment, or any other limitation.
    (b) An insurer may not, under an agreement under section 3 of this chapter, require a dentist to accept an amount set by the insurer as payment for health care services provided to an insured unless the health care services are covered services under the insured's policy.
    (c) An insurer may not provide merely de minimis reimbursement or coverage in an effort to avoid the requirements of this section.
    (d) This section does not apply to a discount medical card program provider agreement regulated under IC 27-17.

SOURCE: IC 27-13-34-15.2; (12)SB0303.2.2. -->     SECTION 2. IC 27-13-34-15.2 IS ADDED TO THE INDIANA CODE AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2012]: Sec. 15.2. (a) As used in this section, "covered services" means limited health services for which any coverage is available under an enrollee's individual contract or group contract, regardless of whether the actual coverage is contractually limited by a deductible, copayment, coinsurance, waiting period, annual or lifetime maximum, frequency limitation, alternative benefit payment, or any other limitation.
    (b) A limited service health maintenance organization may not, under a contract described in section 15 of this chapter, require a dentist to accept an amount set by the limited service health maintenance organization as payment for limited health services provided to an enrollee unless the limited health services are covered services under the enrollee's individual contract or group contract.
    (c) A limited service health maintenance organization may not provide merely de minimis reimbursement or coverage in an effort to avoid the requirements of this section.
    (d) This section does not apply to a discount medical card program provider agreement regulated under IC 27-17.

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