Title: An act relating to participation of denturists in preferred provider networks.

Brief Description: Allowing participation of denturists in preferred provider networks.

Sponsors: Senators Thibaudeau, Deccio, Esser and Franklin.

Brief History:

Committee Activity: Health & Long-Term Care: 2/16/05.

SENATE COMMITTEE ON HEALTH & LONG-TERM CARE

Staff: Sharon Swanson (786-7447)

Background: A denturist is a person licensed to make and maintain a denture. Under current law, health plans covering dental care are required to cover the services of a denturist if such services would be covered if performed by a dentist.

Some health plans utilize a preferred provider network, paying a larger portion of the treatment costs if the enrollee chooses to use certain providers. There is concern that denturists are being systematically excluded from these preferred provider networks.

Summary of Bill: Health carriers must allow denturists to participate in any preferred provider network to the same extent, and under the same terms and conditions, as a dentist.

Health care service contractors or health maintenance organizations that employ one or more denturists, and contract with a group dental practice on a reciprocal exclusive basis, are exempt.

Appropriation: None.

Fiscal Note: Not requested.

Committee/Commission/Task Force Created: No.

Effective Date: Ninety days after adjournment of session in which bill is passed.