2020 -- H 7774 | |
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LC004960 | |
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STATE OF RHODE ISLAND | |
IN GENERAL ASSEMBLY | |
JANUARY SESSION, A.D. 2020 | |
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A N A C T | |
RELATING TO INSURANCE | |
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Introduced By: Representatives Kennedy, Corvese, Azzinaro, Johnston, and Casey | |
Date Introduced: February 26, 2020 | |
Referred To: House Corporations | |
It is enacted by the General Assembly as follows: | |
1 | SECTION 1. Chapter 27-18 of the General Laws entitled "Accident and Sickness Insurance |
2 | Policies" is hereby amended by adding thereto the following section: |
3 | 27-18-85. Third-party access to provider network. |
4 | (a) No contract between a dentist and a health insurance carrier for the provision of |
5 | services to subscribers shall grant to a third party access to a provider network contract, a provider’s |
6 | dental services or contractual discounts, or both unless the contract allows the participating dentist |
7 | to choose to or not to participate in third-party access. |
8 | (b) “Third party” as used herein means any organization, qualified entity, affiliate entity, |
9 | or an entity operating under common control with or under the same brand licensee program as the |
10 | contracting entity, or that operates under or enters into a contract with a contracting entity or with |
11 | another third-party to gain access to a provider network contract. |
12 | SECTION 2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service |
13 | Corporations" is hereby amended by adding thereto the following section: |
14 | 27-19-77. Third-party access to provider network. |
15 | (a) No contract between a dentist and a nonprofit hospital service corporation for the |
16 | provision of services to subscribers shall grant to a third party access to a provider network contract, |
17 | a provider’s dental services or contractual discounts, or both unless the contract allows the |
18 | participating dentist to choose to or not to participate in third-party access. |
19 | (b) “Third party” as used herein means any organization, qualified entity, affiliate entity, |
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1 | or an entity operating under common control with or under the same brand licensee program as the |
2 | contracting entity, or that operates under or enters into a contract with a contracting entity or with |
3 | another third-party to gain access to a provider network contract. |
4 | SECTION 3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service |
5 | Corporations" is hereby amended by adding thereto the following section: |
6 | 27-20-73. Third-party access to provider network. |
7 | (a) No contract between a dentist and a nonprofit medical service corporation for the |
8 | provision of services to subscribers shall grant to a third-party access to a provider network contract, |
9 | a provider’s dental services or contractual discounts, or both unless the contract allows the |
10 | participating dentist to choose to or not to participate in third party access. |
11 | (b) “Third party” as used herein means any organization, qualified entity, affiliate entity, |
12 | or an entity operating under common control with or under the same brand licensee program as the |
13 | contracting entity, or that operates under or enters into a contract with a contracting entity or with |
14 | another third-party to gain access to a provider network contract. |
15 | SECTION 4. Chapter 27-41 of the General Laws entitled "Health Maintenance |
16 | Organizations" is hereby amended by adding thereto the following section: |
17 | 27-41-90. Third-party access to provider network. |
18 | (a) No contract between a dentist and a health maintenance organization for the provision |
19 | of services to subscribers shall grant to a third-party access to a provider network contract, a |
20 | provider’s dental services or contractual discounts, or both unless the contract allows the |
21 | participating dentist to choose to or not to participate in third party access. |
22 | (b) “Third party” as used herein means any organization, qualified entity, affiliate entity, |
23 | or an entity operating under common control with or under the same brand licensee program as the |
24 | contracting entity, or that operates under or enters into a contract with a contracting entity or with |
25 | another third-party to gain access to a provider network contract. |
26 | SECTION 5. Chapter 27-20.1 of the General Laws entitled "Nonprofit Dental Service |
27 | Corporations" is hereby amended by adding thereto the following section: |
28 | 27-20.1-23. Third-party access to provider network. |
29 | (a) No contract between a dentist and a nonprofit dental service corporation for the |
30 | provision of services to subscribers shall grant to a third-party access to a provider network contract, |
31 | a provider’s dental services or contractual discounts, or both unless the contract allows the |
32 | participating dentist to choose to or not to participate in third party access. |
33 | (b) “Third party” as used herein means any organization, qualified entity, affiliate entity, |
34 | or an entity operating under common control with or under the same brand licensee program as the |
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1 | contracting entity, or that operates under or enters into a contract with a contracting entity or with |
2 | another third-party to gain access to a provider network contract. |
3 | SECTION 6. 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 | |
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1 | This act would provide that participating dentists have the right to not participate in third- |
2 | party benefit agreements between nonprofit dental service corporations and outside dental benefit |
3 | plans. |
4 | This act would take effect upon passage. |
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