2019 -- S 0444

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LC001799

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2019

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A N   A C T

RELATING TO INSURANCE -- HEALTH CARE ACCESSIBILITY AND QUALITY

ASSURANCE ACT

     Introduced By: Senator Erin Lynch Prata

     Date Introduced: February 27, 2019

     Referred To: Senate Health & Human Services

     It is enacted by the General Assembly as follows:

     SECTION 1. Section 27-18.8-4 of the General Laws in Chapter 27-18.8 entitled "Health

Care Accessibility and Quality Assurance Act" is hereby amended to read as follows:

     27-18.8-4. Contracts with providers for dental services.

     No contract between a dental plan of a health care entity and a dentist for the provision of

services to beneficiaries may require that a dentist provide services to its patients at a fee set by

the health care entity unless said services are covered services under the applicable subscriber

agreement. "Covered services," as used herein, means services reimbursable reimbursed under the

applicable beneficiary agreement, subject to such contractual limitations on beneficiary benefits

as may apply, including, for example, deductibles, waiting period, or frequency limitations, but

excluding alternate benefit provisions.

     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO INSURANCE -- HEALTH CARE ACCESSIBILITY AND QUALITY

ASSURANCE ACT

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     This act would redefine the term "covered services" as used to describe applicable

subscriber agreements between a health care entity and a dentist, to exclude waiting period and

alternate benefit provisions.

     This act would take effect upon passage.

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LC001799

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