HF 2229 (LSB 5299HV (5) 83)

PROHIBITING THE IMPOSITION BY A DENTAL PLAN OF FEE SCHEDULES FOR THE PROVISION OF DENTAL SERVICES THAT ARE NOT COVERED BY THE PLAN.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  NEW SECTION.  514C.3B  Dental coverage —— fee schedules.
   1.  A contract between a dental plan and a dentist for the provision of services to covered individuals under the plan shall not require that a dentist provide services to those covered individuals at a fee set by the dental plan unless such services are covered services under the dental plan.
   2.  A person or entity providing third-party administrator services shall not make available any dentists in its dentist network to a dental plan that sets fees for dental services that are not covered services.
   3.  For the purposes of this section:
   a.  “Covered services” means services reimbursed under the dental plan.
   b.  “Dental plan” means any policy or contract of insurance which provides for coverage of dental services not in connection with a medical plan that provides for the coverage of medical services.
   4.  Nothing in this section shall be construed as limiting the ability of an insurer or a third-party administrator 

to restrict any of the following as they relate to covered services:
   a.  Balance billing.
   b.  Waiting periods.
   c.  Frequency limitations.
   d.  Deductibles.
   e.  Maximum annual benefits.

______________________________
PATRICK J. MURPHY

Speaker of the House

______________________________
JOHN P. KIBBIE

President of the Senate

   I hereby certify that this bill originated in the House and is known as House File 2229, Eighty-third General Assembly.

______________________________
MARK BRANDSGARD

Chief Clerk of the House
Approved _______________, 2010

______________________________
CHESTER J. CULVER

Governor