H-3453.4 _______________________________________________
HOUSE BILL 2540
_______________________________________________
State of Washington 55th Legislature 1998 Regular Session
By Representatives Dyer, Cody, Skinner, O'Brien, Conway and Murray
Read first time 01/15/98. Referred to Committee on Health Care.
AN ACT Relating to anesthesia and hospital charges for dental care; adding a new section to chapter 41.05 RCW; and adding a new section to chapter 48.43 RCW.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
NEW SECTION. Sec. 1. A new section is added to chapter 41.05 RCW to read as follows:
(1)(a) Each health plan offered to public employees and their covered dependents under this chapter that is not subject to the provisions of Title 48 RCW and is established or renewed after the effective date of this section, and that provides benefits for hospital or medical care shall provide benefits for anesthesia and hospital charges for dental care for a covered person who: (i) Is a child under age six; (ii) is severely disabled; or (iii) has a medical condition requiring hospitalization or general anesthesia for dental care treatment, provided that such services are delivered upon the recommendation of the patient's physician. Prior authorization may be required in the same manner that prior authorization is required for hospitalization for other covered diseases or conditions.
(b) The health plan must also provide coverage for general anesthesia and treatment rendered by a dentist for a medical condition covered by the health plan, regardless of whether the services are provided in a hospital or a dental office.
(2) This section does not prevent the application of standard health plan provisions applicable to other benefits such as deductible or copayment provisions. This section does not limit the authority of the state health care authority to negotiate rates and contract with specific providers. This section does not apply to medicare supplement policies or supplemental contracts covering a specified disease or other limited benefits.
NEW SECTION. Sec. 2. A new section is added to chapter 48.43 RCW to read as follows:
(1)(a) Every health carrier that provides coverage for hospital or medical expenses shall provide coverage for anesthesia and hospital charges for dental care for a covered person who: (i) Is a child under age six; (ii) is severely disabled; or (iii) has a medical condition requiring hospitalization or general anesthesia for dental care treatment, provided that such services are delivered upon the recommendation of the patient's physician. Prior authorization may be required in the same manner that prior authorization is required for hospitalization for other covered diseases or conditions.
(b) Coverage must also include general anesthesia and treatment rendered by a dentist for a medical condition covered, regardless of whether the services are provided in a hospital or a dental office.
(2) This section does not prevent the application of standard policy provisions applicable to other benefits such as deductible or copayment provisions. This section does not limit the authority of an insurer to negotiate rates and contract with specific providers. This section does not apply to medicare supplement policies or supplemental contracts covering a specified disease or other limited benefits.
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