HB 1364-S.E - DIGEST

(DIGEST AS ENACTED)

     Provides that each employee benefit plan offered to public employees that provides coverage for hospital, medical, or ambulatory surgery center services must cover general anesthesia services and related facility charges in conjunction with any dental procedure performed in a hospital or ambulatory surgical center if such anesthesia services and related facility charges are medically necessary because the covered person:

     (1) Is under the age of seven, or physically or developmentally disabled, with a dental condition that cannot be safely and effectively treated in a dental office; or

     (2) Has a medical condition that the person's physician determines would place the person at undue risk if the dental procedure were performed in a dental office.  The procedure must be approved by the person's physician.

     Provides that each group health benefit plan that provides coverage for hospital, medical, or ambulatory surgery center services must cover general anesthesia services and related facility charges in conjunction with any dental procedure performed in a hospital or ambulatory surgical center if such anesthesia services and related facility charges are medically necessary because the covered person:  (1) Is under the age of seven, or physically or developmentally disabled, with a dental condition that cannot be safely and effectively treated in a dental office; or

     (2) Has a medical condition that the person's physician determines would place the person at undue risk if the dental procedure were performed in a dental office.  The procedure must be approved by the person's physician.