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
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
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.
(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.
(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.
