Act of Oct. 24, 2012,P.L. 1472, No. 186 Cl. 85 - HEALTH SECURITY ACT - PROHIBITING INSURERS FROM SETTING FEES FOR NONCOVERED DENTIST SERVICES
Statute Update
Generated 2013-01-08 11:18:45 AM
HEALTH SECURITY ACT - PROHIBITING INSURERS FROM SETTING FEES FOR NONCOVERED DENTIST SERVICES
Act of Oct. 24, 2012,
P.L. 1472,
No. 186
Cl. 85
Session of 2012
No. 2012-186
SB 1144
AN ACT
Amending the act of July 2, 1996 (P.L.514, No.85), entitled "An act providing for certain health insurance benefits to aid the health and well-being of mother and child following the birth of a child; and prohibiting certain practices by insurers," defining "covered dentist services"; and prohibiting insurers from setting fees for noncovered dentist services.
The General Assembly of the Commonwealth of Pennsylvania hereby enacts as follows:
Section 1.
Section 2 of the act of July 2, 1996 (P.L.514, No.85), known as the Health Security Act, is amended by adding a definition to read:
Section 2.
Definitions.
The following words and phrases when used in this act shall have the meanings given to them in this section unless the context clearly indicates otherwise:
"Covered dentist services."
Dental
services for which reimbursement is available under an insured's policy, regardless of whether the reimbursement is contractually limited by a
deductible, copayment, coinsurance, waiting period, annual or lifetime maximum, frequency limitation or alternative benefit payment
.
* * *
Section 2.
The act is amended by adding a section to read:
Section 4.1.
Fees for noncovered
dentist
services.
An insurer's contract with a
dentist
may not require that the
dentist
provide services to the insurer's
insureds
at a fee set by the insurer unless
those services are covered dentist services
.
Section 3.
The addition of section 4.1 of the act shall apply to insurance policies issued or renewed on or after the effective date of this section.
Section 4.
This act shall take effect in 60 days.
APPROVED--The 24th day of October, A.D. 2012.
TOM CORBETT